Preferred Medical Laboratory
To ensure quality of care and allow the member his/her full benefit, Preferred Medical Doctors (PMDs) are required by Section 4.13 of the PMD Agreement to refer laboratory services to a Preferred Medical Laboratory (PML).
Always check eligibility and benefits for patients at each encounter. Some of our benefit plans may require lab work to be done by a certain lab provider to have the highest level of benefits.
Laboratory fee schedules are available online. Look for the "Fee Schedule" link under Payment & Refund in the main menu.
The billing procedures for these services are as follows:
- When a PMD refers a test to a PML, the PML will bill Blue Cross and Blue Shield of Alabama directly for the test. Benefits will be paid according to the fee schedule for PMLs.
- When a PMD refers a test to a non-PML laboratory, the non-PML laboratory will bill Blue Cross directly for the test. However, benefits will be paid under Major Medical when available and subject to any deductible and copayment amounts.
- Clinical laboratories should indicate on their claim the name and NPI number of the physician who referred the test.