Physicians/Specialists
Facilities/Hospitals
Ancillary

Publication Date

Publication Date: 
2017-04-26

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) reminds providers that Avalon Healthcare Solutions (Avalon) manages the exclusive network of independent reference laboratories for Blue Cross NC’s commercially insured and administered products. Only laboratories contracted with Avalon are eligible to provide in-network laboratory services and receive payments under our members’ in-network benefits. If your health care organization makes referrals for Blue Cross NC’s patients’ laboratory tests and services, please review the participating laboratory list to find an eligible, in-network laboratory location. 

Please remember:

  • Your patients with Blue Cross NC coverage depend on participating providers’ use of in-network laboratories. 
  • The costs of lab services are aligned to your patients’ benefit designs.
  • Patients have the lowest out-of-pocket costs when in-network services are obtained.
  • Referrals to out-of-network labs can subject patients to much higher out-of-pocket costs, which can be the full cost when out-of-network benefits are not available. 
  • In addition, using out-of-network lab services will result in higher total costs for medical services, which directly affect the future cost of health care benefits for our members. For this reason, our agreements with participating providers require ordering lab services from in-network laboratories.     

Our use of the Avalon laboratory network applies for all Blue Cross NC insured and administered products for members under the age of 65. This includes, but is not limited to, the North Carolina State Health Plan, the Federal Employees Program, and non-Medicare Advantage products accessed through the BlueCard® program. This change does not affect our Medicare Advantage products or BlueCard members when enrolled in other Blue Cross and Blue Shield-offered Medicare Advantage products.