Laboratory Benefits Management
Laboratory Benefits Management
About
Avalon is an independent company that provides benefits management service on behalf of BlueChoice HealthPlan.
Medical Policies and Clinical Guidelines
Access our policies and guidelines to stay up to date on BlueChoice® coverage, as well as national experts' recommendations.
Use our Laboratory Summary: Common Medical Policy Edits as a quick reference for specific medical policy guidelines for certain laboratory services.
Laboratory Precertification
Learn which lab services require prior authorization by Avalon prior to performing the services and how to get prior authorizations.
Avalon has developed a Lab Procedure Authorization matrix in an effort to help you determine when you need to contact Avalon for precertification. You can submit requests for precertification by fax or by phone. Avalon will promptly review your request and provide a timely, written decision.
Complete this form to request prior authorizations for specific lab services.
Network Laboratories
View a list of the current BlueChoice and Avalon participating laboratory providers.
Resources and Forms
BlueChoice has several online resources that describe the laboratory medical management program in detail. The most commonly used resources are: past webinars, provider news, frequently asked questions and user guides. All can be located at the corresponding links:
If you have questions or would like to learn more, you can contact your Provider Relations Consultant for assistance.