Sequenom Inc

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.They refuse to acknowledge the rude and demeaning behavior of their representative and they did not address as to why they refused to let us speak to a supervisor. The lack of response or any research into the complaint shows me that this is not a concern for them. In business there may be disputes and miscommunications but refusing to discuss a matter and to try and find a resolution is not an acceptable business practice. This place seems to think it is per their response to the complaint. I did some more research and I noticed this is not the first complaint filed with the Revdex.com about this billing discrepancy issue, there were several more complaints about the bill not being as quoted for this exact same test. To date we have not received any calls from this business to try and resolve the dispute. We would prefer to find a solution so this issue is no longer a disputed matter, but that would require this business to make an attempt to resolve. If they are not willing to try and resolve this issue I will be forced to file my next complaints with the Attorney General, CFPB and The Medical Board of California (since the main office is located there).
Regards,
[redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.
At 16 weeks I was given various options by my genetic counselor regarding testing. All prices were given to me and my husband. They recommended Maternity21 since it was more accurate, non-invasive and assured us it would not cost more than $200. Obviously we opted for the Maternity 21 based on price and accuracy. A few weeks later, I received the bill which showed the test cost $2762. My insurance only paid $218 and Sequenom billed us $576. I called them and said according to our counselor it would not cost more than $200. They even showed us a paper stating it will not cost more than$200 whether you are insured or not. The girl at Sequenom customer care stated with coinsurance and so on, we have to pay the difference. I said that was not what I was told or shown. She was not helpful nor did she seem to be interested. I did tell her I will pay the $200 I was quoted because we did not budget for more than that and could not afford more with our baby coming. She was absolutely not interested in hearing me which made me angry. Her response was “That’s ok, it will go into collections and I’m putting a note in your file of this conversation”. It is nice how they send a letter with the bill saying ‘please call with any billing questions and concerns and we’ll be happy to help’! All I received was disinterest and a threat.
I feel like I was very much misled regarding this service. If I did not have insurance, they would bill me $200 and it would be done. Because I have insurance, they billed the insurance company almost $3000, causing “my share” to well exceed the $200. I would not have used this service if they were clear with their advertising, sales pitch and costs. Very misleading. 
 
I sincerely do think that as a company or there counselors should NOT be misleading patients by saying it will not be more than $200. I received another statement a couple of days ago that just says it is going to an outside agency for collection. 
 
Thanks,
[redacted]
[redacted]@gmail.com
717-585-9375

July 17, 2015
 
Roman","serif";
color:windowtext"> 
VIA
ONLINE SUBMISSION
 
Revdex.com of San Diego & Imperial Counties
 
Re: ID # [redacted]
 
Ladies and Gentlemen:
 
Please
accept this response to the above referenced matter involving a question
regarding Sequenom Laboratories’ billing of a patient for its MaterniT21®
PLUS non-invasive prenatal screening test. 
In sum, there appears to be a misunderstanding on the part of the
patient as to her financial obligation and she has omitted several key facts.  We also dispute the patient’s
characterization of communications with us regarding the matter.
 
In
this case, the patient was covered by private health insurance.  In accordance with our contract with that
insurer, it allowed $820.00 to be eligible for payment to Sequenom Laboratories
for its test.  As the patient had not yet
met her in-network deductible, the entire amount was applied to the patient’s
deductible and billed to the patient as governed by her insurance plan.  The attached (redacted) explanation of
benefits from the insurance company outlines the above information.  The patient would have received the
explanation of benefits from the insurer which clearly identifies the patient’s
responsibility of $820.00. Sequenom Laboratories invoiced the patient in
accordance with the explanation of benefits from her insurer, which we are
obligated to do pursuant to our contract with the insurer.
 
Sequenom
Laboratories sent invoices to the patient on March 19, 2015, April 18, 2015,
May 9, 2015 and May 30, 2015 and never received a payment, inquiry or response
from the patient.  In order to fulfill
our obligation to the insurance company to collect the patient’s deductible,
the account was sent to a collection agency on June 22, 2015 – more than three
months after the initial invoice was sent to the patient.  On July 6, 2015, we were contacted for the
first time by the patient’s spouse who was upset that the account was with a
collection agency.  Our representative
explained to him that, once the account has been turned over to a collection
agency, we are no longer able to discuss the account and that all communication
must be with the agency.  We dispute that
our representative was unprofessional or demeaning.
 
The
patient states that the test “should have cost $200.00.” Sequenom Laboratories,
of course, does not know what information was conveyed to the patient by her
healthcare provider.  However, it appears
that the patient’s belief could be based upon Sequenom Laboratories’ Patient’s
Guide (copy attached). 
 
The
Patient’s Guide clearly explains the billing process and the allocations of the
amounts of the charges.  In describing
the explanation of benefits, the guide states: “After your insurance claim has
been processed by your insurer, if your Explanation of Benefits (EOB) indicates
you are to pay a co-pay or deductible, we will send you a bill for the amount
specified.”  This is, in fact, precisely
what was done by Sequenom Laboratories. 
It billed the patient for the amount of her deductible as directed by
her health insurer.  Pursuant to our
contractual arrangement with insurance companies and proper healthcare billing
practices, we are obligated to bill and collect these amounts from patients.
 
The Patient’s Guide also contains a box that describes
typical out-of-pocket costs for in-network HMO and PPO patients (as was the
case here) and does state that “Co-payment for in-network plans is typically $200
or less, after your private insurance deductible is met” (emphasis
added). In fact, in this case, the
patient had no co-payment as the patient’s remaining deductible exceeded $820.00
which is why the patient is responsible for the full amount.  Importantly, the patient’s insurance company
credited this amount to the patient’s deductible which served to reduce the
remaining amount of the deductible applicable to subsequent healthcare costs.
It would be inappropriate for the patient to not pay what she is responsible to
pay under her insurance plan.
 
In
summary, Sequenom Laboratories is confident that its billing practices are
compliant with its contractual obligations to healthcare insurance providers
and with proper healthcare billing practices. 
In addition, our Patient’s Guide is clear and accurate as to how we bill
patients and what charges they should expect and our practice in this case, as
in all cases, was appropriate and entirely consistent with our written
communications.
 
Very truly yours,
 
 
[redacted] D. [redacted]
Senior VP, General Counsel & Secretary
 
[redacted]
Enclosures

Revdex.com
4747 Viewridge Avenue, #200
San Diego, CA 92123-1688
RR: ID # [redacted]
Customer: [redacted]
Address : [redacted]
October 23, 2014
[redacted] 
Direct DiaiSSB[redacted]
Dlrett...

Fax [redacted]
Ladies and Gentlemen:
Please accept this response to the above referenced matter involving a question regarding
Sequenom Laboratories' billing of a patient for its MatemiT21® PLUS non-invasive prenatal
screening test. In sum, there appears to be a misunderstanding on the part of the patient or,
perhaps, a miscommunication by the patient's genetic counselor.
The pricing and billing amounts cited by the patient are not in dispute but the way they
are characterized is incorrect. In this case, the patient was covered by private health insurance.
The cost of the test was $2,762.00 which was the amount billed to the patient's insurance
company. In accordance with our contract with that insurer, it allowed $795.00 to be eligible for 
payment to Sequenom Laboratories for its test. Thus, we have foregone $1,967.00 of the cost of
the test. Of the $795.00 allowed by the insurance company, $483.00 was applied to the patient's
deductible in accordance with her insurance plan and $93.60 represented the amount of her copayment
also as governed by her insurance plan. These two amounts total the $576.60 which
was billed to the patient. The remaining $218.40 was paid by the inslll'Cr. The attached
explanation of benefits from the insurance company outlines the above information.
The patient states that she was informed that the test ''would not cost more than $200"
and that her healthcare provider "showed us a paper stating it will not cost more than $200
whether you are insured or not." Sequenom Laboratories, of course, does not know what
information was conveyed to the patient by her healthcare provider or what paper she may have
been shown. However, it appears that the paper could be Sequenom Laboratories' Patient's
Guide (copy attached).
The Patient's Guide clearly explains the billing process and the allocations of the
amounts of the charge. In describing the explanation of benefits, the guide states: "After your
insurance claim has been processed by your insurer, if your Explanation of Benefits (EOB)
indicates you are to pay a co-pay or deductible, we will send you a bill for the amount specified."
This is, in fact, precisely what was done by Sequenom Laboratories. It billed the patient for the
amount of her co-pay and deductible as directed by her health insurer. Pursuant to our
contractual arrangement with insurance companies and proper healthcare billing practices, we
are obligated to bill and collect these amounts from patients.
The Patient's Guide also contains a box that describes typical out-of-pocket costs for both
in network HMO and PPO patients as well as out-of network HMO and PPO patients and does
state that out-of-pocket costs are ''typically $200 or less." However, it also clearly states that this
is "after your private insurance deductible is met." In fact, in this case, the patient's out-of
pocket cost after meeting her deductible was only $93.60. Importantly, the deductible that was
applied to this test would have been applicable to other insured healthcare expenses had the
patient not received the MatemiT21® PLUS test so this amount does not represent an extra or
added expense for the patient.
Finally, as stated in the Patient's Guide, Sequenom Laboratories does maintain a Patient
Assistance Program which can provide financial assistance such as prompt payment discounts or
interest-free payment terms and we would encourage the patient to contact us if this program is
of interest.
In summary, Sequenom Laboratories is confident that its billing practices are compliant
with its contractual obligations to healthcare insurance providers and with proper healthcare
billing practices. In addition, o'ur Patient's Guide is clear and accurate as to how we bill patients
and what charges they should expect and our practice in this case, as in all cases, was appropriate
and entirely consistent with our written communications.
Very truly yours,
[redacted] D. [redacted]
Sr. Vice President & General Counsel

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" type="#_x0000_t202" o:spid="_x0000_s1026">
 January 18, 2016
 
 
VIA ONLINE SUBMISSION
 
Revdex.com of San Diego & Imperial Counties
 
Re: ID # [redacted]
 
Ladies and Gentlemen:
 
Please accept this response to the above referenced matter involving a question regarding Sequenom Laboratories’ billing of a patient for its MaterniT21® PLUS non-invasive prenatal screening test. 
 
In this case, the patient was covered by private health insurance.  We received the processed claim from the patient’s insurance company on December 31, 2015.  As the patient had not yet met her in-network deductible, $823.50 was applied to the patient’s deductible and billed to the patient as governed by her insurance plan.  The patient should have received the explanation of benefits from the insurer which clearly identifies the patient’s responsibility of $823.50. Sequenom Laboratories invoiced the patient in accordance with the explanation of benefits from her insurer, which we are obligated to do pursuant to our contract with the insurer.
 
Sequenom Laboratories has no record of the patient or her spouse contacting us prior to the test.  We maintain call logs of all calls with patients and we show only one call from the patient’s spouse which was received on January 11, 2016.  During that call, our representative explained the charge and offered a discount if the patient was willing to pay promptly which the spouse refused.  Again, our records do not reflect any conversations with the patient or her spouse other than the call on January 11.  We would also not quote a self-pay cash price of “around $400.”  The self-pay cash price at the time was $995 and is not quoted by us as an estimate.   For a patient with private insurance, the amount for which the patient is responsible is dependent on the patient’s applicable co-pays and the balance of the patient’s deductible obligations.
 
 
Sequenom Laboratories is confident that its billing practices are compliant with its contractual obligations to healthcare insurance providers and with proper healthcare billing practices.  In addition, we are confident that our customer service representatives explain billing maters thoroughly and transparently.
 
Very truly yours,
 
[redacted]
Senior VP, General Counsel & Secretary

Review: At 16 weeks I was given various options by my genetic counselor regarding testing. All prices were given to me and my husband. They recommended Maternity21 since it was more accurate, non-invasive and assured us it would not cost more than $200. Obviously we opted for the Maternity 21 based on price and accuracy. A few weeks later, I received the bill which showed the test cost $2762. My insurance only paid $218.40 and Sequenom billed us $576.60. I called them and said according to our counselor it would not cost more than $200. They even showed us a paper stating it will not cost more than$200 whether you are insured or not. The girl at Sequenom customer care stated with coinsurance and so on, we have to pay the difference. I said that was not what I was told or shown. She was not helpful nor did she seem to be interested. I did tell her I will pay the $200 I was quoted because we did not budget for more than that and could not afford more with our baby coming. She was absolutely not interested in hearing me which made me angry. Her response was “That’s ok, it will go into collections and I’m putting a note in your file of this conversation”. It is nice how they send a letter with the bill saying ‘please call with any billing questions and concerns and we’ll be happy to help’! All I received was disinterest and a threat.

I feel like I was very much misled regarding this service. If I did not have insurance, they would bill me $200 and it would be done. Because I have insurance, they billed the insurance company almost $3000, causing “my share” to well exceed the $200. I would not have used this service if they were clear with their advertising, sales pitch and costs. Very misleading.Desired Settlement: I will definetely pay what I was quoted by my genetic counselor which was $200 but no more. It was very misleading.

Business

Response:

Revdex.com

4747 Viewridge Avenue, #200

San Diego, CA 92123-1688

RR: ID # [redacted]

Customer: [redacted]

Address : [redacted]

October 23, 2014

Direct DiaiSSB[redacted]

Dlrett Fax [redacted]

Ladies and Gentlemen:

Please accept this response to the above referenced matter involving a question regarding

Sequenom Laboratories' billing of a patient for its MatemiT21® PLUS non-invasive prenatal

screening test. In sum, there appears to be a misunderstanding on the part of the patient or,

perhaps, a miscommunication by the patient's genetic counselor.

The pricing and billing amounts cited by the patient are not in dispute but the way they

are characterized is incorrect. In this case, the patient was covered by private health insurance.

The cost of the test was $2,762.00 which was the amount billed to the patient's insurance

company. In accordance with our contract with that insurer, it allowed $795.00 to be eligible for

payment to Sequenom Laboratories for its test. Thus, we have foregone $1,967.00 of the cost of

the test. Of the $795.00 allowed by the insurance company, $483.00 was applied to the patient's

deductible in accordance with her insurance plan and $93.60 represented the amount of her copayment

also as governed by her insurance plan. These two amounts total the $576.60 which

was billed to the patient. The remaining $218.40 was paid by the inslll'Cr. The attached

explanation of benefits from the insurance company outlines the above information.

The patient states that she was informed that the test ''would not cost more than $200"

and that her healthcare provider "showed us a paper stating it will not cost more than $200

whether you are insured or not." Sequenom Laboratories, of course, does not know what

information was conveyed to the patient by her healthcare provider or what paper she may have

been shown. However, it appears that the paper could be Sequenom Laboratories' Patient's

Guide (copy attached).

The Patient's Guide clearly explains the billing process and the allocations of the

amounts of the charge. In describing the explanation of benefits, the guide states: "After your

insurance claim has been processed by your insurer, if your Explanation of Benefits (EOB)

indicates you are to pay a co-pay or deductible, we will send you a bill for the amount specified."

This is, in fact, precisely what was done by Sequenom Laboratories. It billed the patient for the

amount of her co-pay and deductible as directed by her health insurer. Pursuant to our

contractual arrangement with insurance companies and proper healthcare billing practices, we

are obligated to bill and collect these amounts from patients.

The Patient's Guide also contains a box that describes typical out-of-pocket costs for both

in network HMO and PPO patients as well as out-of network HMO and PPO patients and does

state that out-of-pocket costs are ''typically $200 or less." However, it also clearly states that this

is "after your private insurance deductible is met." In fact, in this case, the patient's out-of

pocket cost after meeting her deductible was only $93.60. Importantly, the deductible that was

applied to this test would have been applicable to other insured healthcare expenses had the

patient not received the MatemiT21® PLUS test so this amount does not represent an extra or

added expense for the patient.

Finally, as stated in the Patient's Guide, Sequenom Laboratories does maintain a Patient

Assistance Program which can provide financial assistance such as prompt payment discounts or

interest-free payment terms and we would encourage the patient to contact us if this program is

of interest.

In summary, Sequenom Laboratories is confident that its billing practices are compliant

with its contractual obligations to healthcare insurance providers and with proper healthcare

billing practices. In addition, o'ur Patient's Guide is clear and accurate as to how we bill patients

and what charges they should expect and our practice in this case, as in all cases, was appropriate

and entirely consistent with our written communications.

Very truly yours,

[redacted] D. [redacted]

Sr. Vice President & General Counsel

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

At 16 weeks I was given various options by my genetic counselor regarding testing. All prices were given to me and my husband. They recommended Maternity21 since it was more accurate, non-invasive and assured us it would not cost more than $200. Obviously we opted for the Maternity 21 based on price and accuracy. A few weeks later, I received the bill which showed the test cost $2762. My insurance only paid $218 and Sequenom billed us $576. I called them and said according to our counselor it would not cost more than $200. They even showed us a paper stating it will not cost more than$200 whether you are insured or not. The girl at Sequenom customer care stated with coinsurance and so on, we have to pay the difference. I said that was not what I was told or shown. She was not helpful nor did she seem to be interested. I did tell her I will pay the $200 I was quoted because we did not budget for more than that and could not afford more with our baby coming. She was absolutely not interested in hearing me which made me angry. Her response was “That’s ok, it will go into collections and I’m putting a note in your file of this conversation”. It is nice how they send a letter with the bill saying ‘please call with any billing questions and concerns and we’ll be happy to help’! All I received was disinterest and a threat.

Review: BILLED 2762.00 TO UHC WHEN IT SHOUDL HAVE GONE TO THE VA AS I AM A VETERAN. I'VE ALREADY SPOKEN TO THEM 4 TIMES PLUS THE VA. THEY REFUSE TO UPDATE THEIR RECORDS AND KEEP HARRASSING ME. THEY DON'T KNOW HOW TO PULL THEIR HEADS OUT OF THEIR BUTTS LONG ENOUGH TO LISTEN NOR DO THEIR JOBS. THEY NEED TO REFUND 1242.90 TO UHC AND BILL THE VA AND WORK WITH THEM. THEY NEED TO LEARN WHO THEIR CUSTOMERS ARE AND START DOING THEIR JOBS. THEY NEED TO STOP HARRASSING ME.Desired Settlement: THEY NEED TO REFUND 1242.90 TO UHC AND BILL THE VA AND WORK WITH THEM FOR PAYMENT ON THE 2762 IN CHARGES REGARDING MY NAME. THEY NEED TO LEAVE ME ALONE AS THE VA PAYS AND WORKS OUT AGREEMENTS DIRECTLY WITH COMPANIES. THEY NEED TO LEARN WHO THEIR CUSTOMERS ARE AND START DOING THEIR JOBS. THEY NEED TO STOP HARRASSING ME.

Business

Response:

The Test Requisition Form for this patient's test was sent to us by the ordering physician on

on November 18, 2013, with only UHC insurance listed. We billed UHC and received

payment on December 23, 2013. UHC paid $1157.31 and stated $204.23 was the patient's

co-pay obligation and $157.56 was the patient's deductible obligation. The patient

subsequently contacted Sequenom us to inform that VA should be billed. We received the

VA information from the patient and billed VA on December 17, 2013. The claim was

initially denied by VA as not a covered benefit. On April 16, 2014 VA agreed to process

claim for the full amount. We received $2,762 from VA on April 23, 20114 and a refund was

issued to UHC for $1157.31. We believe the patient's issue has been resolved.

Review: Sequenom misled me on the actual cost of service. They billed me $820 on something that should have cost $200. I tried to discuss this issue, even just pay it so I can move on but the representative at 877-[redacted] option 2 was very unprofessional and demeaning. She offered to let me speak to her manager, then came back on the line and told me I could not talk to her manager. At this point she became belligerent and just kept repeating herself over and over. I realized this call was not going to get anything resolved. I do not understand why a professional business refuses to discuss an issue and at least try to find a resolution. That was not the case here.Desired Settlement: I would like to get this billing dispute resolved but I cannot do that when the representatives refuse to let me speak to a manager and they refuse to discuss the dispute or even try to find a resolution.

Business

Response:

July 17, 2015

VIA

ONLINE SUBMISSION

Revdex.com of San Diego & Imperial Counties

Re: ID # [redacted]

Ladies and Gentlemen:

Please

accept this response to the above referenced matter involving a question

regarding Sequenom Laboratories’ billing of a patient for its MaterniT21®

PLUS non-invasive prenatal screening test.

In sum, there appears to be a misunderstanding on the part of the

patient as to her financial obligation and she has omitted several key facts. We also dispute the patient’s

characterization of communications with us regarding the matter.

In

this case, the patient was covered by private health insurance. In accordance with our contract with that

insurer, it allowed $820.00 to be eligible for payment to Sequenom Laboratories

for its test. As the patient had not yet

met her in-network deductible, the entire amount was applied to the patient’s

deductible and billed to the patient as governed by her insurance plan. The attached (redacted) explanation of

benefits from the insurance company outlines the above information. The patient would have received the

explanation of benefits from the insurer which clearly identifies the patient’s

responsibility of $820.00. Sequenom Laboratories invoiced the patient in

accordance with the explanation of benefits from her insurer, which we are

obligated to do pursuant to our contract with the insurer.

Sequenom

Laboratories sent invoices to the patient on March 19, 2015, April 18, 2015,

May 9, 2015 and May 30, 2015 and never received a payment, inquiry or response

from the patient. In order to fulfill

our obligation to the insurance company to collect the patient’s deductible,

the account was sent to a collection agency on June 22, 2015 – more than three

months after the initial invoice was sent to the patient. On July 6, 2015, we were contacted for the

first time by the patient’s spouse who was upset that the account was with a

collection agency. Our representative

explained to him that, once the account has been turned over to a collection

agency, we are no longer able to discuss the account and that all communication

must be with the agency. We dispute that

our representative was unprofessional or demeaning.

The

patient states that the test “should have cost $200.00.” Sequenom Laboratories,

of course, does not know what information was conveyed to the patient by her

healthcare provider. However, it appears

that the patient’s belief could be based upon Sequenom Laboratories’ Patient’s

Guide (copy attached).

The

Patient’s Guide clearly explains the billing process and the allocations of the

amounts of the charges. In describing

the explanation of benefits, the guide states: “After your insurance claim has

been processed by your insurer, if your Explanation of Benefits (EOB) indicates

you are to pay a co-pay or deductible, we will send you a bill for the amount

specified.” This is, in fact, precisely

what was done by Sequenom Laboratories.

It billed the patient for the amount of her deductible as directed by

her health insurer. Pursuant to our

contractual arrangement with insurance companies and proper healthcare billing

practices, we are obligated to bill and collect these amounts from patients.

The Patient’s Guide also contains a box that describes

typical out-of-pocket costs for in-network HMO and PPO patients (as was the

case here) and does state that “Co-payment for in-network plans is typically $200

or less, after your private insurance deductible is met” (emphasis

added). In fact, in this case, the

patient had no co-payment as the patient’s remaining deductible exceeded $820.00

which is why the patient is responsible for the full amount. Importantly, the patient’s insurance company

credited this amount to the patient’s deductible which served to reduce the

remaining amount of the deductible applicable to subsequent healthcare costs.

It would be inappropriate for the patient to not pay what she is responsible to

pay under her insurance plan.

In

summary, Sequenom Laboratories is confident that its billing practices are

compliant with its contractual obligations to healthcare insurance providers

and with proper healthcare billing practices.

In addition, our Patient’s Guide is clear and accurate as to how we bill

patients and what charges they should expect and our practice in this case, as

in all cases, was appropriate and entirely consistent with our written

communications.

Very truly yours,

[redacted] D. [redacted]

Senior VP, General Counsel & Secretary

Enclosures

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.They refuse to acknowledge the rude and demeaning behavior of their representative and they did not address as to why they refused to let us speak to a supervisor. The lack of response or any research into the complaint shows me that this is not a concern for them. In business there may be disputes and miscommunications but refusing to discuss a matter and to try and find a resolution is not an acceptable business practice. This place seems to think it is per their response to the complaint. I did some more research and I noticed this is not the first complaint filed with the Revdex.com about this billing discrepancy issue, there were several more complaints about the bill not being as quoted for this exact same test. To date we have not received any calls from this business to try and resolve the dispute. We would prefer to find a solution so this issue is no longer a disputed matter, but that would require this business to make an attempt to resolve. If they are not willing to try and resolve this issue I will be forced to file my next complaints with the Attorney General, CFPB and The Medical Board of California (since the main office is located there).

Regards,

Business

Response:

Sequenom Laboratories provided a detailed and complete response to the consumer's complaint. The consumer's response is a recitation of the initial complaint. As such, Sequenom Laboratories has no further response.

Review: I've received a bill from Sequenom in the amount for $761.31. I do not owe them anything because I paid for the test in full. They told me that my insurance company would not pay for the test and therefore, I would assume the full responsibility which was $235.00. I discussed it with my husband and we agreed to pay the whole amount of $235. Now They are charging me for an additional $761.31. They said they filed a claim with my insurance company and that a check was sent out. I was never informed about the claim, in fact I was told that this was not covered and I would have to pay the whole amount. Now years later they are charging me with the amount of $761.31. I don't understand because I paid the whole amount.Desired Settlement: Bill adjusted as paid in full in the amount of $235.00

Business

Response:

Blue Cross Blue Shield of Texase paid the patient directly for the amount of Sequenom's

charges covered by insurance, in the amount of $761.31. The patients is obligated to

provide this amount to Sequenom and also obligated to to pay her co-pay amount of $235.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.

I have paid in full for the test. There was never a mention of a co-pay or deductible because my insurance made it clear from the beginning that they would not pay. I have not received payment from the insurance company. Here is an article of what they are doing to me and others: http://www.[redacted].com/weblogs/news-ticker/2013/oct/03/more-trouble-for-seque...⇄

Review: At 20 weeks pregnant, I was presented with two options for genetic testing - a new test that offered 99% accuracy and the standard test that often came with false positives. I asked the genetic counselor what the cost of the newer test was, she replied "the maximum out of pocket cost to you would be $235." I determined this was within our budget and worth the cost for increased peace of mind. It turns out the cost of the test was over $2700. Our insurance company covered about $1300 and Sequenom is now expecting the balance. My husband and I have tried since January 2013 to get in touch with their billing department (which kindly asks you to leave your information and they'll get back to you). When I never heard back after the third time leaving a message, I sent them correspondence along with the reimbursement check asking if that money along with $235 pay out from us would suffice to balance out the account. No response. Flash forward a month and a half later and Maria Gonzalez from Sequenom was leaving me voicemails. When we spoke live she explained that my account was put into collections (and revealing that's who she was working for) and that she wanted to know if I could pay the $235 to settle the account right then and there. I pulled out my credit card, relayed my information and in return she promised to send me a bill detailing the transaction and showing a balance of $0 on the account. Not only was my credit card never charged, but I received a bill this week from Sequenom for $1066 with no explanation, no response to my original correspondence. However, it did come with their stock form letter to call their billing department with any questions or concerns and they'd be happy to work with me.Desired Settlement: I want to pay them what I was quoted by the genetic counselor and the collections agency -- $235, which I've been attempting to do since January 2013. After that, I want documentation that the account balance is $0. I do not want to hear from Sequenom or their collections agency ever again.

Business

Response:

We are a diagnostic testing laboratory. We bill health insurers where the patient has

insurance. Some insurers issue payment directly to the insured patient rather than to us

and we are then in the position of needing to seek the payment of the insured amount and

any deductible or co-pay amount from the patient. Some patients deny receiving payment

from their insurers.

The test at issue here was performed in October 2012. The patient's insurance (Blue Cross

of Pennsylvania) paid the patient directly the amount of $1,325.95, stating that $1,069.55

was the patient's responsibility as deductible and coinsurance showed as $569.55. The

patent forwarded to us the payment made to her by Blue Cross. We agreed to accept

payment of $235 in full satisfaction of patient's remaining obligation of $1,069.55. A

statement was mailed to the patient on April 29, 2013 showing a zero balance and no frther

obligation. Thus we believe we have provided the patient with the desired resolution.

Review: My wife got pregnant last July. Our OB suggested us to do the Maternity21 plus exam since she is over 35 years old. We called the Sequenom lab and asked for the price. At that time we were told if we go through insurance the total will be $200 and self-pay cash price will be around $400. Then we decided to go through insurance. But the bill we received is $823.50, even twice as high as the self-pay cash price. I called again and talked to their billing staff, whose name is [redacted]. Then she told me she could lower the price to $587. I asked her why the price after going insurance is higher than self-pay price and why it was different than the price we were told before. She answered that the price given before was an estimate, not an exact price. It looks like their price system is cannot be trusted at all. For one lab exam, we heard so many different prices. I think they are misleading customers on purpose before we chose the billing method for the exam. The account number for my wife's exam is [redacted].Desired Settlement: We are willing to pay the invoice as self-pay cash price when they told us last year, which should be around $400.

Business

Response:

Review: When my wife was pregnant, she was advised to have genetic testing done. When we called the company to inquire as to cost, we were told not to go through insurance because it is more expensive and if we pay out of pocket, there was a sliding scale as to cost. Due to our income and communication from the company, we were assured there would be no cost to us. Our agreement was that because it was free, we would proceed with the test. We decided that only then could we afford to do so, as we are both teachers.

REcently, we received a bill for $500 for the services. Although my wife was able to reduce the cost to $200, it is still more than the agreed to amount.Desired Settlement: We have paid the $200, but we would like to be refunded the amount in full. This would fulfill the original terms of our verbal agreement.

Business

Response:

The test at issue here was performed in April 2013. The patient's health insurance was

billed for the test and we received payment of $955.28 from the insurance company in

August 2013.

The patient's insurance stated that the patient had a co-pay obligation of $238.82 a

deductible obligation of $186.90. We accepted the patient's payment of $200 and wrote-off

the balance of $225.72 in September 2013 pursuant to our Patient Assistance program.

We do not and cannot, as a matter of law and regulation, represent that our laboratory

testing services are free to any patient.

Review: the sale representative, Mr [redacted] contacts me and told me that The Sequenom Co charged $289 -$995 for blood test,MaterniT21PLUS test. I asked him why there are big range for same test.

He told me that the company will charge the insurance higher price. For patients who has no insurance will be charged for $289,if pay cash,or checks. He then sent 5 tests to me. My first blood test performed on 03/03/14, was billed for $995, without any explanation. I called the company billing department ,they can't explain why I was billed for highest price $995. Unfortunately, my 2nd test was charged unreasonably high $ 2762 on 04/14/14 for the same test. I can't get an reasonable explanation from the company again.Desired Settlement: I sincerely ask Sequenom to contact me @[redacted]. So we can reach a settlement for the charges. I like to pay them ASAP, but with a reasonable and fair price.

Review: My doctor recommended this fetal test. I was told that the cost would be 0-250 even if my insurance rejected the test. This was their established business practice in order to obtain new business (see recently filed shareholder lawsuit over the price cutting scheme to fraudulently inflate stock prices)As expected my insurance rejected their bill. Instead of adjusting it as promised this company fraudulently claims that [redacted] reimbursed me in full and sent me to collections. These types of business practices are deplorable, especially when you are involving vulnerable pregnant women.Desired Settlement: I want this deleted from my credit reports

Business

Response:

The test at issue here was performed in June 2012. A claim was submitted to the patient's

insurer, Blue Cross of California. The claim was processed by Blue Cross in October 2012. ,

Blue Cross reported on multiple occasions that it had paid the allowed amount of $1309.72

directly to the patient. Additionally, Blue Cross reported that the patient's co-pay obligation

was $561.28. The Patient was advised by Sequenom to contact her insurance to discuss

whether or not she received and cashed the check. Blue Cross has stated that is the patient

did not deposit the check they are willing to reissue the payment, but only to the patient.