No. It means there’s a possibility that your health insurer may not pay for the testing, per their specific coverage policy.
How to read your Quest bill
Understanding the full cost of your care is an important aspect of managing your health. Take a look at sample lab bills to make sure you know which tests were performed, how much is covered by your health insurance, and how much you owe.
Sample laboratory bills: Quest Diagnostics, AmeriPath, and Dermpath Diagnostics
Quest and insurance
To give you access to advanced testing options and trusted results, Quest partners with some of the biggest names in health insurance, like UnitedHealthcare®, Aetna®, Humana®, Cigna®, and most Anthem® and BlueCross BlueShield® plans—just to name a few.
Advance Written Notice (AWN)
Navigating health plan coverage policies can be complex. Quest Diagnostics is here to help. Health plans do not cover all healthcare services. In certain cases, for tests that Quest knows are likely not covered based on a health plan’s policies, we’ll issue you an Advance Written Notification (AWN) to notify you of your potential financial responsibility, and we’ll ask that you review and sign it if you’d like to proceed with the service(s).
Frequently asked questions about AWN
An AWN—also referred to as an Advanced Beneficiary Notice (ABN)—is a notice given to you before receiving certain services or laboratory tests, notifying you that:
- Some testing may not be covered by your health plan, and payment will likely be denied for the service(s)
- You may contact your plan to better understand if the service(s) will be covered. You then have the choice whether or not to move forward with the service(s)
- You will be personally and fully responsible for payment if your health plan denies payment
The AWN provides pricing transparency for the test(s) and gives you the opportunity to make an informed healthcare decision—prior to the service(s) being provided—about whether to accept the financial responsibility and receive the service(s).
If we have reason to believe that your health plan will not pay for a test your doctor has ordered for you, you will be given the AWN and asked to sign it before the testing is performed. Each time there is reason to believe that your health plan will not cover a particular test, you may be asked to sign a new AWN that specifies the test(s) in question and the reason that the insurer may not pay for the test(s). You will be provided transparent pricing to make an informed decision, and may still appeal the denial of coverage in accordance with your plan’s policies.
Option 1: You may sign the AWN, agreeing to be financially responsible for the charge(s) and have the test(s) performed. You may be billed for the test(s) if your health plan denies payment.
Option 2: You may choose not to have the test(s) performed. It is advisable that you consult with your physician should you decide to not have the test(s) performed. You may also contact your plan to better understand the coverage policy.
After we perform the tests, in most cases, your health insurance company will be billed. If insurance pays in full, you will not receive a bill. In certain cases, some health plans have advised not to bill them for services that are known to be denied. You will be notified, asked to sign the AWN, and will be billed directly by Quest Diagnostics should you agree to move forward with testing.
Not Medically Necessary: A decision by your health insurer that your treatment, test, or procedure is not necessary for your health or to treat a diagnosed medical problem. Medically Necessary testing includes tests needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.
Frequency Limitations: When health insurer policies indicate how often certain treatments, tests, or procedures may be performed during a given time period. These are more complex to track but require patient notification.
Experimental or Investigational: Certain tests have not yet been approved or cleared according to some health plans’ policies based on their specific interpretation of the test(s) and associated medical criteria.
AWNs are not new. From time to time, health plans make changes to covered tests based on medical necessity, frequency limitations, and tests determined to be considered experimental or for investigational use. To better understand coverage policies specific to your plan, please reach out to your health plan directly.
Other payment options
Payment plans
We offer payment plans which allow those who are unable to pay their full balance by the due date to make monthly installment payments. To get started, contact billing by calling 1.866.MYQUEST.
Financial Assistance
Through our Patient Assistance Program, we tailor solutions for uninsured or underinsured patients based on individual circumstances and may adjust some or all laboratory charges if you cannot afford to pay for your testing.
Self-pay without using insurance: Protect yourself against surprise medical bills
If you are not using insurance, you have the right to receive a good faith estimate explaining how much your medical care will cost.
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You can quickly and easily pay your bills online at any time.
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