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Periodic Contributor

Quest Diagnostics should be dropped as AARP UHC preferred lab.

Quest Diagnostics should be dropped by AARP.  It only accepts one insurance at a time, Medicare,  and then bills the patient for the amount that AARP UHC Supplement covers.

 

This can only be remedied by going to the Quest web site and jumping though loops to change the insurance on there to the supplement. Many seniors will pay the amount not realizing it should have been paid for by their supplement.  

 

This happened to me last year and has again happened this year.  I am deeply disappointed in UHC  for their choice of  Quest Diagnostics as their preferred lab.

 

Others accept both Medicare and the Supplement and the patient does not receive a bill.  WHY is AARP using Quest Diagnostics?   

 

My blood tests are automatically sent to Quest since it is the preferred company chosen by UHC.  Why would AARP select a company who does not accept both Medicare and the Supplement's information.  Other companies do.  This practice of Quest is harmful to seniors causing them out-of-pocket cost that should have been paid for by their AARP Supplement insurance. 

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Honored Social Butterfly

Your doctor is responsible for coding your test when they send it to Quest.

Your doctor is responsible for giving Quest your Medicare information

Quest should bill Medicare just as your doctor does.

Medicare knows that you have Supplemental coverage (Medigap) and it is their responsibility to send the claim on to your Supplemental (Medigap) insurer for their further processing.  This is the way it is suppose to work to make it seamless and pretty much effortless. 

 

Quest does not bill your Supplemental Medicare (Medigap) policy insurer.  Your Medigap insurer receives it from Medicare and sends the correct amount to the provider of the service as long as it has been covered and paid by Medicare.

 

https://www.medicare.gov/supplements-other-insurance/whats-medicare-supplement-insurance-medigap 

 

Your Medigap coverage is just that " GAP coverage" - it is gonna pick up the remaining 20% of the Medicare paid amount - Medicare pays 80% of the amount for which they are responsible (their contracted amount) for any service covered under Part B that is medically necessary AND is covered by Medicare.

 

Your doctor may order test more often than what Medicare will pay - in that event, your Doc should have you sign an ABN (Advance Beneficiary Notice of Non-coverage) so that you are aware that this might not be covered.

It's Always Something . . . . Roseanna Roseannadanna
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Periodic Contributor

Quest is not working like you say it should.  What you say is correct and that is how other companies handled my routine annual blood test in the past.

 

But last year Quest only took what Medicare paid and then sent me a bill saying I owed the rest. I almost paid it but then thought, this can’t be right, and I called my doctor’s office. They said Quest is only accepting ONE insurance and that I would have to go into their web site and see if I could get them to also take the AARP Supplement F that I have. They sounded unhappy with Quest.

 

I did go to Quest web site and I had a heck of a time getting it to allow me to enter the AARP information. Finally, I deleted the Medicare and only then would the Quest web site allow me to enter the AARP Supplement information.  UHC then paid the bill. 

 

 I meant to tell my doctor’s office not to use Quest anymore but with the Covid stuff going on I forgot to. So, again this year I get a bill from Quest. I go into their web site, click around until I can find the correct method of entering the AARP UHC Supplement F information. Quest then  sent me an e-mail saying they will now bill AARP. Hopefully the do and all goes well.  

 

Perhaps it is unintentional on Quest’s part and it is a software glitch, but if so, they need to fix it.   It has been two years now.

 

Since AARP has chosen them as their “preferred lab” all my tests go to them by default. Hopefully, next year I will remember to tell my doctor not to use them. 

 

My question is, “Why has UHC chosen them as their preferred lab when they will not accept AARP UHC Supplement insurance unless the patient manually goes in and jumps through the at times confusing hoops to manually enter AARP’s insurance?”  Not all Seniors have the computer knowledge to do that and they are ending up paying a bill that in reality they do not owe. 

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@corgi67530 this may be helpful.

 

You can use Quest Diagnostics for many tests your doctor might order. If you have original Medicare (parts A and B), Medicare Part B will generally cover your tests.

However, your test must meet some specific criteria:

It must be ordered by a doctor.
That doctor must participate in Medicare.
The test must be for a diagnostic service that Medicare covers.
The Quest Diagnostics location must participate in Medicare.

 

https://www.healthline.com/health/medicare/does-quest-diagnostics-accept-medicare#medicare-coverage

 

Neither AARP or your Medigap carrier are in a position to designate a "preferred" provider.

 

If you have original Medicare you and your doctor can use ANY lab that participates in Medicare.

 

I don't know if you messed things up by "deleting" Medicare from your profile or not. I guess you will find out the next time you have lab work.

 

If the lab used does not participate in Medicare you could encounter additional charges. Most claims filed with Medigap carriers come directly from Medicare. It is rare for a provider, or patient, to file direct with the carrier.

 

How the Medigap carrier deals with a "stranger filed" claim will vary from carrier to carrier.

 

It is difficult to follow your post. Perhaps I missed something.

 

Paragraphs help.

 


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Periodic Contributor

Quest Diagnostics posted online last year that they were very proud to be a preferred lab selected by United Health Care.  As you will notice in this excerpt taken from United Health Care web page, they are one of the listed preferred labs. See below:

 

Last year they only accepted ONE insurance at a time, the patient had to go into their web site and manually change that insurance to the second insurance.

 

Their web site would only accept one insurance. The first insurance, in my case it was Medicare had to be removed before I was allowed by the web site to type in the second.  It was physically impossible to type in the AARP UHC until Medicare was removed. There was only 1 place to put 1 insurance.   Once I deleted Medicare and typed in the UHC information, Quest did bill my AARP Supplement F and it paid for the bill. 

 

This year, I again received a bill from Quest for $88.07. It had ONLY BILLED MEDICARE and now said I owed the rest.   I once again had to go into their web site, jump through the loops and get it to accept my second insurance, the Supplement.

 I did not have to delete Medicare this year.  Yeah! We are making progress.

 

The blood test was a routine annual blood test. It is covered. There was nothing unusual added to it.  It has ALWAYS be paid for in the past with no action on my part until United Health Care selected Quest as a preferred lab. 

 

My doctor’s office said that Quest has been a problem because of this. So I am not the only one having this problem with Quest.

 

My concern is for the seniors who do not have a computer or who do not have computer ability.  They are getting ripped off.  

See the copied and pasted information below: 

 

05/2019: UnitedHealthcare Preferred Lab Network Launches July 1, 2019

We are excited to announce the following labs were selected to be part of the Preferred Lab Network effective July 1, 2019:

AmeriPath Inc.

BioReference Laboratories, Inc.

GeneDX

Invitae Corporation

LabCorp

Mayo Clinic Laboratories

Quest Diagnostics Inc. 

 

Honored Social Butterfly

From reading your post, I hope I can clarify a point that maybe the source of your confusion -

United HealhCare is a writer of many different types of health insurance -

UHC Health insurance maybe what some employers use -

UHC Health Insurance may write individual coverage - on and off of the Obamacare exchange

UHC Health Insurance also writes Medicare Advantage Plans under Medicare 

EACH OF THESE ARE DIFFERENT TYPES OF HEALTH  INSURANCE coverage.

AND

They write Medigap insurance in connection with traditional or original Medicare.

 

YOU HAVE MEDICARE as your insurer - the claims should go thru to Medicare.

You do not have United Healthcare as your insurer - you have a Medigap plan under Medicare which could be under any number of insurer names - yours just so happens to be UHC.

You pay your monthly premiums for your Medigap coverage to United HealthCare.

I repeat MEDICARE is your insurer - they are in control not your Medigap insurer.  It does NOT matter who your Medigap insurer considers preferrred anything because it is MEDICARE that is control.

 

Like somarco said - the service has to be covered by Medicare - YOUR INSURER  - Medicare will send your claim ON TO your Medigap insurance company when they finish processing your claim.

You will know that it is covered if Medicare pays their share (80%) of the amount they have contacted.

 

MEDICARE - Your Insurer controls the process. 

Your MSN ( Medicare Summary Notice) will indicate what they have paid to Quest - as long as the Quest Lab you are using is a Medicare provider - if not, that too is shown on your MSN.

Look at your codes on your MSN - if eveything is working as it should, meaning your services is covered and the provider is covered, one of the codes should say that they have sent this claim onto your (whatever) Medigap or Medicare Supplemental insurer to process the rest of the claim.

Quest ONLY has to submit the claim to Medicare NOT to UHC Medigap.

Once your Medigap insurer has processed their part of the claim - you will get another summary from them showing what they paid.

 

Yes, I have provider like labs or radiology that send me a bill in the middle of the process - That is their routine because they handle so many different type of health insurance claims.  but I know, being on Medicare,  not to pay it until the whole claim is complete - meaning that Medicare pays and then the Supplemental insurer pays

 

You should check out your Medicare Summary Notice that you received on this QUEST claim and see what it says in the coding.    If it says what I think it says, you better make sure that Quest still has MEDICARE down as your insurer and that you have not changed it to UHC.

 

To see this particular MSN - you should either have a paper copy OR it can be seen on your MyMedicare account.

 

See the codes at the bottom of this example of the Medicare MSN - NOTE the one that is marked B

Screenshot_2020-10-25 Medicare Summary Notice Part B - summarynoticeb pdf.png

 

https://www.medicare.gov/sites/default/files/2019-08/summarynoticeb.pdf 

 

It's Always Something . . . . Roseanna Roseannadanna
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Bronze Conversationalist

@corgi67530 a "preferred" lab means nothing. You are ALLOWED to use ANY Medicare participating lab.

 

Carriers that say they have "preferred" providers mean those providers have agreed to accept a lower reimbursement from the Medigap carrier. These arrangements benefit the carrier, not you.

 

If things are working out to your satisfaction, talk to your agent and let him or her explain how it works.


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Periodic Contributor

Quest Diagnostics posted online last year that they were very proud to be a preferred lab selected by United Health Care.  As you will notice in this excerpt taken from United Health Care web page, they are one of the listed preferred labs. See below:

 

Last year they only accepted ONE insurance at a time, the patient had to go into their web site and manually change that insurance to the second insurance.

 

Their web site would only accept one insurance. The first insurance, in my case it was Medicare had to be removed before I was allowed by the web site to type in the second.  It was physically impossible to type in the AARP UHC until Medicare was removed. There was only 1 place to put 1 insurance.   Once I deleted Medicare and typed in the UHC information, Quest did bill my AARP Supplement F and it paid for the bill. 

 

 

This year, I again received a bill from Quest for $88.07. It had ONLY BILLED MEDICARE and now said I owed the rest.   I once again had to go into their web site, jump through the loops and get it to accept my second insurance, the Supplement.

 

 I did not have to delete Medicare this year.  Yeah! We are making progress.

 

The blood test was a routine annual blood test. It is covered.  It has ALWAYS be paid for in the past with no action on my part until United Health Care selected Quest as a preferred lab. 

 

My doctor’s office said that Quest has been a problem because of this. So I am not the only one having this problem with Quest. My concern is for the seniors who do not have a computer or who do not have computer ability.  They are getting ripped off.  

 

05/2019: UnitedHealthcare Preferred Lab Network Launches July 1, 2019

We are excited to announce the following labs were selected to be part of the Preferred Lab Network effective July 1, 2019:

AmeriPath Inc.

BioReference Laboratories, Inc.

GeneDX

Invitae Corporation

LabCorp

Mayo Clinic Laboratories

Quest Diagnostics Inc. 

 

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