Doctor used out of network lab despite our request not too

My fiancé recently had blood work taken by our primary care physician to do a complete checkup on her.  Before the appointment, we verified that her insurance does cover the blood work, but it must be performed by Quest.  We verified with the doctor ahead of her appointment that they use Quest labs.  We also took the step of informing the doctor in the appointment that our insurance will only work with Quest, and he assured us that’s not a problem.  Two weeks later, we have a bill over $2K for work performed by Health Diagnostic Laboratory.... NOT QUEST!  Needless to say, we are both a bit mad over this.  I know usually these errors occur when patients make false assumptions about what the doctors office is doing, but in this case, we went out of our way to ensure they used the right lab, and it still got messed up.  Could the Doctors office be liable for this sort of mistake?

[Amir Mostafaie]

Dear Fryelock,

Based on your note it sounds like you took every possible step to ensure your benefits are covered according to your plan guidelines & the Doctor’s Office has clearly made a mistake in this case and yes they can be liable. You may need to get more information from that Doctor’s Office on their process & procedures (regarding sending test samples to labs), so you can make an educated guess on how this happened. You may also be able to narrow down who in the office made that mistake. You will then make your case through a formal letter (in 3 copies) & submit 1 copy to the Doctor, 1 to your insurance company & 1 to the lab. You letter should be addressed to the Doctor & you should request a response within 10 business days. That way you give the Doctor time to do his research & respond to you.

Sincerely,

Amir Mostafaie