Hello! For some context, my girlfriend enrolled in Keystone Health Plan East (Independence Blue Cross), an HMO, through the open market exchange. In February 2022, she had a visit with her primary care physician who ordered blood work done. The lab the physician used was Quest Diagnostics. Doing a quick google search, it seems that back in 2014 the insurance signed an exclusive deal with Lab Corp as the only in network provider for lab services. Clearly, we were not informed of this and neither was her physician.
Fast forward into March and she receives a letter from her insurance saying that the blood work was done through an out of network provider and a list of the tests done and the total cost, around $1,100. The letter explicitly said it wasn’t a bill and one would follow. We have never received a bill and today Quest Diagnostics sent a letter asking for the reimbursement payment, which we never received, or an explanation of benefits if we didn’t receive a reimbursement.
Are we on the hook for the full bill? What can be done about this?
Any help navigating this process would be greatly appreciated and thank you for reading up until this point.
submitted by /u/happy_tiny_jellyfish
[link] [comments]Hello! For some context, my girlfriend enrolled in Keystone Health Plan East (Independence Blue Cross), an HMO, through the open market exchange. In February 2022, she had a visit with her primary care physician who ordered blood work done. The lab the physician used was Quest Diagnostics. Doing a quick google search, it seems that back in 2014 the insurance signed an exclusive deal with Lab Corp as the only in network provider for lab services. Clearly, we were not informed of this and neither was her physician. Fast forward into March and she receives a letter from her insurance saying that the blood work was done through an out of network provider and a list of the tests done and the total cost, around $1,100. The letter explicitly said it wasn’t a bill and one would follow. We have never received a bill and today Quest Diagnostics sent a letter asking for the reimbursement payment, which we never received, or an explanation of benefits if we didn’t receive a reimbursement. Are we on the hook for the full bill? What can be done about this? Any help navigating this process would be greatly appreciated and thank you for reading up until this point. submitted by /u/happy_tiny_jellyfish [link] [comments]Read Morer/HealthInsurance