State: Florida
Insurance: Cigna
Service Provider: Quest Diagnostics
Service Provided: Vitamin D, 25 Hydroxy blood test
Summary
After I complained of insomnia and fatigue, my doctor ordered a blood test for Vitamin D, 25 Hydroxy. I got the test at Quest Diagnostics, who then billed my insurer $544. My insurer will not cover $241 since they determined the test was “not medically necessary”.
I can order a Vitamin D, 25 Hydroxy test from Quest Diagnostics for $49 through Direct Labs (scroll down to see the price). I have done this before. Had I known that Quest would over-bill my insurance by 11x the price, I would have simply ordered direct and sent the results to my doctor.
I think I have a few options:
Appeal the decision with Cigna and argue the test was medically necessary, since I had symptoms and was found to be Vitamin D deficient. Ask Cigna to not pay anything, and contact Quest to negotiate payment with them directly. Tell Cigna I’m just not going to pay the balance since I was over-charged. Contact my local representative?
I’d like to ask advice from this sub on what other options I may have, and any advice for how to proceed. Ideally, if I can negotiate directly with Quest, I think I can get them to lower the price. Has anyone successfully gone this route?
Thank you.
submitted by /u/Feroys_1111
[link] [comments]State: Florida Insurance: Cigna Service Provider: Quest Diagnostics Service Provided: Vitamin D, 25 Hydroxy blood test Summary After I complained of insomnia and fatigue, my doctor ordered a blood test for Vitamin D, 25 Hydroxy. I got the test at Quest Diagnostics, who then billed my insurer $544. My insurer will not cover $241 since they determined the test was “not medically necessary”. I can order a Vitamin D, 25 Hydroxy test from Quest Diagnostics for $49 through Direct Labs (scroll down to see the price). I have done this before. Had I known that Quest would over-bill my insurance by 11x the price, I would have simply ordered direct and sent the results to my doctor. I think I have a few options: Appeal the decision with Cigna and argue the test was medically necessary, since I had symptoms and was found to be Vitamin D deficient. Ask Cigna to not pay anything, and contact Quest to negotiate payment with them directly. Tell Cigna I’m just not going to pay the balance since I was over-charged. Contact my local representative? I’d like to ask advice from this sub on what other options I may have, and any advice for how to proceed. Ideally, if I can negotiate directly with Quest, I think I can get them to lower the price. Has anyone successfully gone this route? Thank you. submitted by /u/Feroys_1111 [link] [comments]Read Morer/HealthInsurance