- the story of how lab tests for an Annual Wellness exam resulted in a $1,832.64 bill from Quest -
Let’s get this out of the way first: I am a healthy adult
woman. I have no fundamental illnesses
and never have. I eat healthy, exercise
regularly, my weight is proportional to my height (120lbs, 5’3”), I take no
medications on a regular basis.
Now, here’s my story.
I moved to a new town (Naples, FL) and went to a new doctor,
Dr. Lindita Hobdari as a new patient and for an annual wellness exam (aka
‘annual physical’). At the time of this exam, I had health care coverage with
United Health Care through my husband’s employer. Of later irony, subsequent to his retirement
we switched healthcare coverage to Blue Cross/Blue Shield of Michigan; more on
this later!
As part of the annual wellness exam, Dr. Hobdari ordered an
extensive set of lab tests; this is apparently routine for her office for new
patients. About the same time, my
husband went to the same doctor for the same annual wellness exam and was
ordered a very similar full set of blood tests.
When I left Dr. Hobdari’s office, the front-desk staff asked
me if I had a personal Lab preference. I
said I did not given I was new to the area, so I asked who they would recommend
that was nearby. I was handed a brochure for Quest Diagnostics. Parenthetically
– and unbeknownst to me given our appointments were not coinciding – my husband
was asked the same question and because he was more familiar with the
surrounding area and had an online record with LabCorp, he said that is where
he would go. My husband went and had his
tests done first, total bill to the insurance company was $2,087, plan
discounts $1,551.97, United Healthcare paid $481.55, out of pocket cost to us:
$53.48
I didn’t think for a second about him going to LabCorp vs.
me going to Quest Diagnostics, because over the years I’ve gone to
Quest Diagnostics for a routine lab here and there, though not recently. I found a Quest Diagnostics lab close to home,
and off I went. I handed my insurance
card at the front office, they smiled, processed it, invited me in, I got all
the tests done.
My bill comes from Quest Diagnostics and guess what?! Total bill to the insurance company was
$3,277.36, plan discounts $0. Yup! ZERO!
Because as it turns out United Healthcare doesn’t have a contract with
Quest Diagnostics. When I called Dr.
Hobdari’s office almost in tears, I was told “everybody knows United Healthcare doesn’t have a contract with
Quest Diagnostics!” When I suggested
that given this statement it was odd that the Hobdari office staff would –
knowing I was with United Healthcare – offer me a choice and give me a pamphlet
for Quest Diagnostics, I was then told: “You
are an educated person. You should have
checked to make sure it was covered.”
When I then called Quest Diagnostics
and asked why they would take me in for the tests after I showed them my United
Healthcare insurance card which they would have “known” was not accepted by
their company … well they didn’t have a better response either nor did they
have a solution. Essentially they did
not accept responsibility for giving me care knowing all along I would not have
coverage!
And now the plot starts to thicken. UnitedHealthcare paid Quest Diagnostics – as
an “out of network service” $1,444.72 of
the$3,277.36, leaving my share $1,832.64.
Really?! So let’s
look at this. Virtually identical set of
lab tests, same insurance company, husband goes to LabCorp (in network), I go
to Quest (out of network):
LabCorp (Husband):
Total Bill = $2,087.00; UHC Plan Discounts = $1,551.97; UHC Plan Paid = $481.55
We paid = $53.48
TOTAL RECEIVED BY LabCorp for tests: $535.03
Quest Diagnostics (me):
Total Bill = $3,277.36; UHC Plan Discounts = $0; UHC Plan Paid = $1,444.72
TOTAL RECEIVED BY QuestDiagnostics for tests so far: $1,444.72
And yet Quest Diagnostics still wants another $1,832.64! Does this make sense? I didn’t think so. They already received nearly $900 more than
LabCorp for the same panel of tests!
I understand that ‘caveat emptor’ applies, but how can two
entities that as part of their business KNEW that Quest Diagonstics would not be
‘in network’ for my insurance: a) send me to Quest Diagnostics (Hobdari Family
Health); and b) accept me at the door without comment (Quest Diagnostics Inc.)?
Further, Quest Diagnostics has already received significantly
more in payment for a battery of tests than their competitor, LabCorp. The ‘Out-of-Network’ issue worked in their
favor to the tune of $900+ but they still want more!
I have since been in touch with Quest Diagnostics. I went through customer service and was eventually
routed to a Billing Office Supervisor (Tina) – who told me “she would take care of
it.” Well, apparently how she took care
of it was to try to get United Healthcare to reconsider paying Quest Diagnostics
more of the $1,832.64 balance! When that
didn’t work … well, now Quest Diagnostics sent me another bill for that
balance.
Now for further irony.
A few weeks ago, now covered by BCBS-Michigan under a new plan following
my husband’s retirement and our switch to my employers carrier, I went back to
the same lab for a couple of tests (vitamin B12, vitamin D) and handed the person at the front desk my
insurance card. I asked her if they can
tell if my insurance covers the tests.
She said: “No. But we can see the patient
share of the bill so can ensure we charge you at the time of the service.” I almost lost it, but of course there was no
point in taking it out on the person who checked me in, who was not the same
person as the one who checked me in several months ago. I wanted to ask her: “When you see a patient balance due of “1,832.64” you don’t feel
compelled to let the patient know that?”
Apparently not, because like most people, had I known a set of routine
labs would saddle me up with a $1,800 bill, I would have left the lab immediately
with all my blood still in my body!
As for my next step (July 2014), I will try to reach an
executive at Quest Diagnostics to get their help. I understand I bear some responsibility
here. But so should my healthcare
provider (Hobdari Family Health) and the lab itself (Quest Diagnostics). I do not understand why I – and
UnitedHealthcare of course – should be asked to bear the full burden of this
“misunderstanding.”
If anyone has any suggestions I’d love to hear them. Please comment below!
