Checked lab was in network (they were!) Insurance still denied coverage anyway and owe the amount
1) online appointment with plushcare. Plushcare checks insurance and doctor and all in network and just $15 copay. Great!
2) Doctor orders some very basic labs at quest (lipid panel + CMP)
3) I know quest labs in in network with my insurance (anthem) but check specific location anyway in insurance directory. Address, phone number, all Blue checks "this provider is network" reassuring
4) my insurance covers labs with zero copay. I've done tons of lipid panels with them with no issue.
4) go to lab, do tests .. a few weeks later..
5) insurance denies coverages. Quest wants their money.
Took a long why to figure out. But this is what happened. Quest is indeed in network with my plan but the ordering provider from plushcare is not licensed in California where I live (just Florida). Plushcare never revealed this and frankly I wouldn't have thought much of it. Insurance denied because of this. Quest doesn't really care and wants the ~$500. After fighting I got this down to sub 100 that I eventually paid.
Insurance is still an illusion of coverage in USA if providers can charge you whatever they want after the fact, without ever providing you a estimate. Wasn't NSA supposed to help with this?
submitted by /u/reddlvr
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