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Lab Tests & X-Rays

  • Lab Services

    Eligible lab services are covered only if you use in-network clinical laboratory providers for members enrolled in Horizon HMO Access:

    When you need clinical laboratory tests, your PCP may collect specimens at his or her office for testing by an in-network lab, or send you to a LabCorp, Quest or AtlantiCare patient service center.

    • If you go to an in-network patient service center, be sure to bring your member ID card, as you may be asked to complete forms. If you get a bill from LabCorp, Quest or AtlantiCare Clinical Laboratories, please contact Member Services.

    • If you use a testing facility other than LabCorp, Quest or AtlantiCare Clinical Laboratories, your tests will not be covered and you will have to pay the total cost of the lab services.

  • X-rays or Imaging Scans

    We work with eviCore healthcare for non-emergency outpatient radiology and diagnostic imaging services. eviCore healthcare will help schedule and manage your outpatient radiology and diagnostic imaging, determine whether a service is medically necessary and confirm a location for the service.

    If your PCP decides that you need an X-ray or scan, they will ask you to call eviCore healthcare’s Scheduling Line at 1-866-969-1234. Representatives are available weekdays, from 7 a.m. to 7 p.m., ET.

    The eviCore healthcare scheduling staff will coordinate with the in-network imaging center of your choice to schedule your exam and provide you with a confirmation number. You won’t need a referral for most radiology services.

    However, if you schedule radiology services at a hospital outpatient department, your PCP must provide you with a referral form. You can use eviCore healthcare’s Scheduling Line to make an appointment at a hospital outpatient department, but eviCore healthcare cannot issue a confirmation number as a referral to a hospital outpatient department.

    Advanced imaging services

    Your PCP must call eviCore healthcare before you get these services:

    • CT/CTA scans
    • Diagnostic left-heart catheterization
    • Echo stress tests
    • Echocardiograms
    • MRIs/MRAs
    • Nuclear medicine studies (including nuclear cardiology)
    • PET scans

    For more information about X-rays and imaging, please refer to your SPD or Benefit Booklet for coverage details.