IBC PPO Member - Frequently Asked Questions

Frequently Asked Questions
Independence Blue Cross® Personal Choice® PPO Members
Q1.
A1.
Is Quest Diagnostics contracted with Independence Blue Cross?
As of July 1, 2014 Quest Diagnostics is no longer contracted with Independence Blue Cross
(IBC). Quest Diagnostics is now an out-of-network provider with IBC.
Q2.
Can Independence Blue Cross Personal Choice PPO members go to Quest Diagnostics
even if Quest Diagnostics is not a contracted lab?
If your plan includes an out-of network benefit, you have the choice to continue to choose
Quest Diagnostics; however, if your plan does not offer an out of network benefit you should
consider using an in-network lab. If you have questions or concerns please call 800-326-7341
to speak with a Quest Diagnostics billing specialist, or email us at
[email protected]
A2.
Q3.
A3.
Q4.
A4.
As an Independence Blue Cross Personal Choice PPO member, what happens if I go to
a Quest Diagnostics Patient Service Center or my physician sends my labs to
Quest Diagnostics?
Quest Diagnostics will file a claim with Independence Blue Cross as an out-of-network provider
based on the services provided. As a member with an out-of-network benefit plan, instead of
the plan directly paying Quest Diagnostics, IBC may send you a reimbursement check along
with the Explanation of Benefits (EOB). This reimbursement policy is typically in accordance
with the plan’s out-of-network benefit, which allows you to go to your provider of choice.
Will Quest Diagnostics send me a bill for any remaining fees due?
For Independence Blue Cross Personal Choice PPO members:
If you reside in Pennsylvania, we will not bill you beyond what your health plan has
reimbursed. We ask that you endorse the check from Independence Blue Cross and send it to
Quest Diagnostics.
If you do not send us the check, we will send you an invoice for the amount of the check as a
reminder.
If you reside in New York or Florida, we will follow the billing instructions received from IBC.
Independence Blue Cross Personal Choice PPO Member FAQ
Q5.
A5.
Q6.
A6.
Are there any exceptions to Quest Diagnostics billing policy for Independence Blue
Cross Personal Choice PPO members?
Yes. If you are a BlueCard® PPO member and see a physician outside of the Philadelphia five
counties (Bucks, Chester, Delaware, Montgomery, Philadelphia), your claim is subject to the
BlueCard rules. This means that the claim is subject to the rules of the plan processing the
claim. For example, if you visit a physician in New York City the physician would file the claim
with Empire BCBS. Because we are an in- network (contracted) provider with Empire BCBS,
that claim is subject to our contract terms with Empire BCBS, regardless of our status with
Independence Blue Cross. This means that if there is patient responsibility (for any applicable
co-pays, co-insurance, or deductibles), you as an Independence Blue Cross Personal Choice
PPO member in PA will receive a bill from Quest Diagnostics.
Which “Blues Plans” is Quest Diagnostics in-network with in Pennsylvania?
•
•
•
•
Q7.
A7.
Highmark® Blue Shield® (Central PA & Lehigh Valley)
Highmark Blue Cross Blue Shield (Western PA)
Blue Cross Northeastern PA
Capital Blue Cross
- Keystone Health Plan Central
Where do I go or where should my provider / doctor go if we have questions?
Quest Diagnostics has established a team of specialists to address inquiries from patients and
physicians regarding diagnostics services for Independence Blue Cross members.
QUEST DIAGNOSTICS BILLING SPECIALISTS
Quest Diagnostics
LBX #740775
Billing Address
PO BOX 5900
Cincinnati, OH 45273-9917
Patient Billing Phone Number
800-766-2604
Physician calling on behalf of IBC patient
800-326-7341
QuestDiagnostics.com
Quest, Quest Diagnostics, any associated logos, and all associated Quest Diagnostics registered or unregistered trademarks are the property of Quest Diagnostics. All third party marks—® and ™—are
the property of their respective owners. © 2014 Quest Diagnostics Incorporated. All rights reserved.
Information is believed to be accurate as of the production date; however, it is subject to change.
July 2014 / LIT CODE

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