FFC people with Aetna???

Discussion in 'Fibromyalgia Main Forum' started by meowchowchow, Nov 22, 2005.

  1. meowchowchow

    meowchowchow New Member

    I filed all my blood work for Quest Diag. with Aetna...I received 12, that's right 12 different bills today for my bloodwork totalling over $3000. I'm freaking. Aetna is saying they already billed my insurance. I need to call them tomorrow.

    Each bill says "Paid by insurance" = amount and "Disallowance" - amount.

    Anyone know what a "disallowance is?

  2. karatelady52

    karatelady52 New Member

    Don't freak out yet. I did the exact same thing. I gathered them all up and paid them not realizing that some of them were duplicates and as each blood test was approved, they reduced the bill. As time went by, we kept getting more and more "paid" ones and the amount owed went down.

    Look at the number at the top right corner of the page. You will see some of them are the same. Only pay the smallest amount. Also, wait until they get finished and you'll see you won't owe much.

    Does that make sense?

    The problem we had was getting reimbursed. It was for about $2,000. I don't know why they bill that way. Its very confusing.

  3. meowchowchow

    meowchowchow New Member

    Thank you! I Was starting to freak. I didn't look to see if they were duplicates.

  4. simka

    simka New Member

    I don't know about FFC, but when I had Aetna Quest was a network provider.

    Most health providers have a "billed" amount which is often considerably more than the amount typically paid by insurance. They have agreements with different insurance companies about how much they will accept from the insurance company for each test, etc.

    So if Quest "bills" $100 for a test, the amount Aetna agrees to pay may be $40 (it varies a lot), and the $60 may be reflected as a disallowance. If you have a copay for lab tests of 20%, you would get billed by Quest for 20% of the $40, and Aetna would pay 80% of that amount.

    There may also be some tests that the insurance doesn't cover, etc. I never ran into these with Quest.

    There may be cases where insurer initially disallows payment, until they get further information.

    After all the processing, Quest sends you a bill for your share. I have not heard where the insurer bills you. They just send a statement of benefits.

    I hope this helps.

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