Quest Diagnostics / illegal balance billing
Be careful about paying bills from Quest Diagnostics. Both my husband and myself have been "balance billed" by Quest for labwork. Quest is a preferred provider for both our insurance companies. Our insurance companies secure deep discounts from Quest for services (ex. insurance pays $30 when Quest billed for $310). Quest is not happy about this despite the fact that they freely enter into these contracts with the insurance companies when they agree to be preferred providers.
My insurance company has a co-insurance amount for labwork. My husbands does not, so he owes labs nothing for services provided. Quest first sent me a bill for the total amount they billed to the insurance company, and noted on their invoice that I was to remit a copy of my insurance company "explanation of benefits" if it showed I owed a lesser amount. I included the payment I owed per the explanation of benefits, and remitted a copy to Quest patient billing. At that time I thought my business with Quest was done.
Two weeks later I receive another bill from Quest. This bill showed my payment credited to my account, and a balance due for the difference between the entire amount billed and my payment. I called Quest and spoke to an extraordinarily rude individual who advised me to "just pay it" and when I asked to be transferred to customer service, she hung up on me. I called back and spoke to someone else who gave me a fax number and told me to fax a copy of my explanation of benefits to her. I did as I was instructed. My balance was not resolved after two weeks, so I called my insurance company. My insurance company advised me that Quest engaged in "balance billing" and that, after reviewing my records, I did not owe Quest anything other than what was indicated on the insurance explanation of benefits. My insurance company said they would contact Quest about the matter. A week later I received a letter from my insurance company stating that they sent Quest a copy of my explanation of benefits, and that they informed Quest that I owed only the amount per the explanation of benefits.
Today (two weeks later) I receive a letter from Quest advising me that my account is past due and they are going to send it to a collection agency. Their letter also informed me that "based on the explanation of benefits received from [my] insurance company, this balance is [my] responsibility". Funny how MY insurance company told me it wasn't. Guess my insurance company is trying to ruin my credit, huh? More likely Quest is trying to shake me down for the money. I am in the process of writing letters to Quest, my attorney, my insurance company, several news media agencies, my state representatives at the state and federal level, the New York State Health Insurance Department, and the New York State Attorney General's office. Quest has run afoul of the New York State AG before - see http://www.oag.state.ny.us/media_center/2003/jun/jun25a_03.html.
I can only quess that Quest engages in this highly illegal practice as it is so profitable for them. I have the education and the resources to fight this injustice. Quest must find that there are many people who will just fork over the money to avoid a hassle or because they fear collection agencies. Quest has tried to victimize the wrong person this time.
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