Designated Diagnostic Providers

Using your benefits for outpatient lab services

Maybe you've heard about Designated Diagnostic Provider benefits or maybe it's a new benefit to you. If you get your health insurance through your employer, it's important to know the details because it may affect your coverage for outpatient lab services. Let's go over what it is and how it works. 

What is a Designated Diagnostic Provider?

Designated Diagnostic Providers are laboratory providers that meet certain quality and efficiency requirements. If you have a Designated Diagnostic Provider benefit, you’ll have the highest level of coverage — and likely save money — when you use  Designated Diagnostic Providers for your outpatient lab services. 

How do I know if I have Designated Diagnostic Provider benefits?

You can sign in to myuhc.com, call the number on your member ID card or look for the Designated Diagnostic Provider icon on your card to learn if these benefits apply to you. If you have Designated Diagnostic Provider benefits and you don’t use a Designated Diagnostic Provider, you may have a higher cost-share and end up paying more out-of-pocket for your outpatient lab services. 

How do I find a Designated Diagnostic Provider?

To find a Designated Diagnostic Provider near you, sign in to myuhc.com and select Find Care and Costs or use the UnitedHealthcare app. Look for the green check that indicates a provider is a Designated Diagnostic Provider. Here's an example:

When do I need to use a Designated Diagnostic Provider for lab tests or services?

Using a Designated Diagnostic Provider may help you save money on many common lab services. If you need lab work, be sure to tell your doctor which Designated Diagnostic Provider to use. Designated Diagnostic Provider benefits apply to most outpatient services, including:

  • Blood draws

  • Blood glucose tests

  • Metabolic tests/panels

  • Rapid strep tests

  • Comprehensive metabolic panel

  • General health panel

  • Electrolyte panel

  • Obstetric panel (including HIV testing)

  • Renal function panel

  • Acute hepatitis panel

  • Hepatic function panel

  • Drug tests

  • Insulin tolerance panel

Frequently asked questions (FAQs) about Designated Diagnostic Providers

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Footnotes

Designated Diagnostic Provider is a special designation provided to some categories of providers in certain states and funding types in recognition of their efficiency and quality. Some benefit plans or certificates of coverage will limit or reduce benefits if services are provided by in-network providers who are not also identified as a Designated Diagnostic Provider. Please note, Designated Diagnostic Provider is not applicable in all states and/or coverage options. If Designated Diagnostic Provider is not applicable, the Designated Diagnostic Provider designation or lack of designation will have no impact on your benefits. Please refer to your schedule of benefits to determine if Designated Diagnostic Provider designation is applicable to your coverage. If Designated Diagnostic Provider is applicable and you are having difficulty finding a Designated Diagnostic Provider provider on this search tool or have other questions, you may contact us by calling the number on your ID card.