A bill over a year later

Hi there,

My job pays for a subscription for us for Dr. On Demand.

I had a telehealth appointment through the app where the doctor suggested I have labs completed.

She sent me to a lab that was in network with my health insurance (BCBS of Illinois). Because she searched through my insurance plan for a lab that was in network, I thought I was in the clear for these labs. I have the core PPO plan which I pay a lot for.

I got the labs completed, and in the BCBS app it showed the labs as being fully paid.

Well, a year later I received a bill from Quest Diagnostics for $1083.

I called them, and they said that the claim was denied.

I called my insurance, and they finally have adjusted it claiming it as out of network because the Dr that ordered the labs is in California? Even though I went through a lab that is in network. I am so confused.

I think I'm also confused because I have BCBS of Illinois (my jobs hub is in Chicago) and they're claiming that the claims are processed "where the service provider is housed which was California".

I don't live in Illinois, I live in NH. So why have I never had this issue before with say, a PCP provider in NH?

Does this sound right? Because I hit my out of pocket max last year they're saying I owe $600 instead. I am just completely baffled that these potential charges weren't presented to me and over a year later I'm stuck with this bill.

Do I have any chance of appealing this? I have the original screenshot where it shows the labs as in network and the screenshot of where it shows the labs (now) as out of network.

submitted by /u/Soggy_Difficulty_608
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