Quest Diagnostics — fraudulent billing
For a YEAR, I had a running battle with Quest Diagnostics regarding billing for a set of laboratory tests requested by one of my physicians. When the sent the bill to Blue Cross Blue Shield for reimbursement, Quest used a diagnostic code that was different from what the doctor used on the requesting prescription, AND also they requested the reimbursement in the category of "medical care" instead of "diagnostic pathology." As a result, of course, BCBS denied the claim and Quest sent me a bill for$626.80, which is more than six times the "usual and customary" cost for that set of tests. For a while I went round and round with Quest, then I contacted BCBS and was told that the claim would be paid if Quest resubmitted with appropriate codes. I contacted Quest with this information, but they resubmitted the bill again with the same old codes they had used previously. Finally I contacted my physician and asked her office to intervene on my behalf. It took multiple interventions on my physician's part, including formal appeals to BCBS, before BCBS finally paid the claim. The "allowable amount" turned out to be $98.11, of which I was supposed to be responsible for 10% co-pay and BCBS paid the remaining $88.33 directly to Quest. Elapsed time: one full year. Interestingly, I have not yet received a corrected billing from Quest. I sent them payment along with a copy of BCBS's Explanation of Benefits. We'll see what happens. I don't trust these folks.
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