Sonora Quest Laboratories

Dear Dispute resolution consultant:Thank you for your correspondence and for providing us an opportunity to investigate and respond to Mr. [redacted] complaint.Upon review of Mr. [redacted] account, for the date of service 1/07/2014 Mr. [redacted] provided a copy of his [redacted] insurance card at...

the time of service.  [redacted] was billed and processed the claim on 01/28/2014.  Per [redacted]’s explanation of benefits, the patient responsibility for this claim was $207.31 which Mr. [redacted] paid on 02/25/2014.  Although Mr. [redacted] indicates he spoke to our Customer Service Department we cannot locate any communication with Mr. [redacted] in February or April 2014 regarding 1/07/2014 date of service. Mr. [redacted] insurance did not recoup their payment on this claim until February 10, 2015.   Sonora Quest Laboratories is past timely filing for his current insurance plan due to the delayed recoupment by [redacted].   We will attempt an appeal of his claim with the insurance company; [redacted].In regards to Mr. [redacted] recent date of service listed as 1/26/2015 we have confirmed with our Client Services department that the report for the services being billed was available to his physician’s office on 1/27/2015 via their electronic ordering system ([redacted]).We hope this addresses Mr. [redacted] concern.  [redacted]Billing Customer Service Assistant Supervisor

January 12, 2015Revdex.com4428 N 12th StreetPhoenix, AZ 85015-4585Attn:  Maria GarciaRE: Complaint ID #[redacted]- [redacted]Dear: Maria GarciaIt is unfortunate Mr. [redacted] did not find our first response satisfactory.  We can only reiterate our position on Mr. [redacted]’s inquiry.  Sonora Quest Laboratories as an ancillary provider relies on the information provided by the ordering physician and the patient.  Our billing system is not centric and each visit is a separate account and previous information does not carry over.  Mr. [redacted]’s insurance information was not lost, but the order was submit by the physician’s office with the incorrect insurance information.  Mr. [redacted] was sent several statements, but never reached out to us on the bill he believes he does not owe, until December of 2014.  This unresponsiveness left us with no opportunity to bill his insurance.We sent Mr. [redacted] a total of 4 letters and none were returned to us as a bad address.  RSI Collections also sent 6 letters for this date of service along with letters on the 9 other accounts of ours for Mr. [redacted] that are in collections for non-payment.  None of the letters were returned to the collection agency.   Contractually we only have 180 days to bill [redacted] Insurance.  Since the correct insurance was not provided within the 180 days, [redacted] will no longer consider our claim for payment.  We have explained this to Mr. [redacted].  Again we can send Mr. [redacted] a claim form that he can attach to his invoice and submit to his correct insurance for this date of service.  His insurance will accept a claim for him as there is not a timely filing limit of 180 days for the patient to self -submit to his own insurance company.   Sincerely[redacted]Customer Service SupervisorSonora Quest Laboratories

April 29, 2016Revdex.com 4428 N. 12th StreetPhoenix, AZ 85014RE: Complaint ID #[redacted]- [redacted] - RebuttalDear Dispute Resolution Specialist: We have taken Mr. [redacted] comments under advisement in regards to our website appointment scheduling. It will take time to determine the best solution and make changes if they are accepted. I assure you we will evaluate this part of our appointment scheduling process as well as options available for different testing types. I have already reached out to the laboratory to work on a solution to make this particular test type more available which should benefit not only Mr. [redacted], but other patients. My apologies for any rudeness or condescending manner that Mr. [redacted] felt he received and too, my apologies for any inconvenience in regards to his phone calls or the scheduling issue. We make every effort to provide our customers with the best service we can and I am sorry if we fell short in meeting his needs and expectations. Sincerely,Barbara D[redacted], Patient Services DirectorSonora Quest Laboratories

We apologize our response dated 4/6/2015 did not satisfy Mr. [redacted] dispute.  Unfortunately we cannot locate any contact with Mr. [redacted] in October 2014. Our research has confirmed Mr. [redacted] physicians’ office order testing for June 2014 to be performed by Sonora Quest Laboratories.  The testing was rendered by Sonora Quest Laboratories and no part of the testing was sent out to any  outside laboratory.  The office manager [redacted], at [redacted] stated they do use an [redacted] laboratory for certain testing but she confirmed the testing for 6-6-2014 was only sent to Sonora Quest for testing.  We maintain our original conclusion that Mr. [redacted] has not received duplicate billing by Sonora Quest Laboratories and the charges are valid. If Mr. [redacted] has any additional questions regarding any invoices he is receiving for another laboratory he will need to contact his physician office.  We hope this resolves this matter.Sincerely, 

Billing ustomer Service Supervisor

February 18, 2015Revdex.com4428 N. 12th StreetPhoenix, AZ 85015-4585Attn:  Dispute Resolution ConsultantRE: Complain ID #[redacted]Dear Dispute Resolution Consultant:Thank you for your correspondence and for providing us an...

opportunity to investigate and respond to Ms. [redacted] inquiry.Upon reviewing Ms. [redacted] account we found the account was forwarded to our collections agency for returned mail, not due to non-payment.  The amount due was not reported to any credit bureau. Sonora Quest Laboratories as an ancillary provider relies on the information provided to us on the requisition.  Every service is independent from another.  Any changes made to one invoice do not affect other accounts. Sonora Quest Laboratories has policy of collecting past due balances when patients present for new laboratory services.  The Tucson area has just recently started this practice, so Ms. [redacted] could have been in prior to this month and not asked for payment on this invoice.  Ms. [redacted] insurance was billed for this date of service and processed the claim leaving $66.39 as patient responsibility.   Ms. [redacted] would have also received an explanation of benefits from her insurance company with this information.  Even though Ms. [redacted] no longer has United Healthcare as her insurance, they would still have her claim on file and could verify this amount was her responsibility. To address Ms. [redacted] concern about being refused services, we are not the exclusive provider of laboratory services with Ms. [redacted] current insurance.  She is able to seek laboratory services at any other laboratory.  We hope this clarifies Ms. [redacted] concerns. Sincerely[redacted] Billing Customer Service Supervisor

January 5, 2016Revdex.com 4428 N. 12th StreetPhoenix, AZ 85014RE: Complaint ID [redacted]Dear: Dispute Resolution SpecialistTo assist with bringing resolution to Ms. [redacted] concerns, a member of our billing team contacted Ms. [redacted] insurance company by phone on 01/04/2016 to confirm that the claim which was denied on 12/23/15 had been properly adjudicated.   Per the representative that our billing team member spoke with, the diagnosis code provided was not a supportive code for the specific test ordered by Ms. [redacted] provider and as a result, the recent determination on 12/23/15 accurately reflects Ms. [redacted] patient responsibility.  In addition, a member of our staff contacted the ordering provider to confirm that Sonora Quest has the correct diagnosis codes on file; a representative from the physician’s office did confirm the diagnosis information we show on record is correct and as a result, their office will not provide us with any further updates or revisions to the diagnosis codes for this order.  It is always the intent of our billing department to thoroughly resolve concerns on behalf of our patients.  The insurance company’s claim determination does validate that Sonora Quest Laboratories billed Ms. [redacted] appropriately; however, I recognize that this outcome does not meet the expectations of our patient.  For that reason and as a gesture of goodwill, I have authorized the full adjustment of Ms. [redacted] account.  Going forward, it is imperative that if Ms. [redacted] has any questions regarding what tests will be covered by her health plan, that she reach out to her insurance company to discuss any potential patient responsibility in advance.  Thank you for your correspondence and for providing us with an opportunity to investigate this dispute.  I sincerely hope that the proposed resolution addresses Ms. [redacted] concerns.Sincerely,Nichole K[redacted]Billing ManagerSonora Quest Laboratories

I do not accept this responses. I personally talked to an [redacted] claim rep with Melissa from the doctor's office on the phone. [redacted] said they would process the claim with the corrected code of T86.10. Melissa called Sonora Quest on 11/18 and spoke to someone that said they would resubmit the claim with the corrected code. When I called to inquire about the claim on 12/28, I was told by Sonora Quest that there was no documentation that the claim was resubmitted to [redacted] That is when I filed this complaint.
A[redacted] has stated that there is no time limit for filing a corrected claim. Sonora Quest claim that the time limit ran out is incorrect. They are lying about reprocessing this claim.

May 19, 2016Revdex.com of Southern Arizona5151 E. Broadway Blvd #100Tucson, AZ 85711Attn:  Valerie Ramos RE: Complaint ID #[redacted]- [redacted]Dear Dispute Resolution Consultant:Thank you for your correspondence and for...

providing us an opportunity to investigate and respond to Ms. [redacted].  Ms. [redacted] communicated in her dispute letter that genetic testing she did not specifically request was performed as a result of her visit to our patient service center on February 1, 2016; however, our records indicate that Ms. [redacted]’s provider signed a letter of attestation indicating that they take responsibility for obtaining  informed consent prior to her testing being ordered.  As an ancillary provider, Sonora Quest Laboratories proceeded with performing the testing that was specifically requested by Ms. [redacted]’s provider.The claim for the testing ordered by Ms. [redacted]’s provider was submitted to her insurance plan Blue Cross Blue Shield on 02/12/2016 and on 03/03/2016, Ms. [redacted]’s insurance provider denied the testing, stating the service is not covered under Ms. [redacted]’s benefit plan.  The Sonora Quest Laboratories billing team takes every measure possible to assist our patients with coordinating their insurance coverage for all ordered services, in fact, our call records confirm that two separate members of the Sonora Quest Laboratories customer service team communicated with Ms. [redacted] on 03/24/2016 and 04/04/2016 and provided Ms. [redacted] guidance on the information that would be required for our reimbursements team to file an appeal to Ms. [redacted]’s insurance provider.  Updated diagnosis codes were provided by Ms. [redacted]’s provider on 04/14/2016 and an appeal was filed on Ms. [redacted]’s behalf on 04/30/2016; unfortunately, Blue Cross denied the appeal request on 05/17/2016, reaffirming their original determination that the patient’s health plan does not cover this test.  As a courtesy and to assist Ms. [redacted] with resolving her account balance, we can extend a 30% discount to Ms. [redacted] and we can also offer her a five payment plan to help mitigate the financial impact of this unforeseen outcome.  To take advantage of this offer, please contact our customer service department at ###-###-#### between the hours of 7am and 5pm, Monday through Friday.Sincerely,Anthony G[redacted]Anthony G[redacted]Billing Customer Service SupervisorSonora Quest Laboratories

I have reviewed the response made by the business in reference to complaint ID [redacted] and find that this resolution would be satisfactory to me, however will the negative information that the collection agency has been reporting about me be...

removed from my credit report and repaired.  Thank you again for your assistance in this matter.  

Regards,

This is absolutely nonsense. I have never heard from Sonora Quest, and I have been covered by [redacted] and [redacted]  for many years. I also am not easily intimidated by anyone. I was NYPD, and lived in Brooklyn, N.Y. most of my life. I will, therefore, be contacting my attorney, and possibly [redacted] news. It is not a matter of $261.61 at this point, it is a matter of principle.

I have been to Sonora Quest Labs before and have had no issue besides a bit of a wait time, which I should have made a reservation so that is my own issue. This last time I left extremely upset about my visit. I had to have more blood drawn than usual, 4 larger tubes and 2 smaller tubes, all while fasting. I began to feel light headed and got cold sweats as soon as the man finished taking my blood. If I saw someone who was obviously looking ill or uncomfortable AFTER giving blood, I wouldn't try to rush them to the bathroom for a urine sample, but I'll give him the benefit of the doubt (but working in such a place, he should know the signs for someone who is looking uncomfortablle) and maybe he didn't notice I wasn't feeling good. After he asked me to use the restroom, I told him I wasn't feeling well. He got me the smallest cup of water while I sat in the chair trying not to dry heave, all while having cold sweats. He stayed in the room while I drank my water, but did not even try to make conversation or ask how I was feeling. The minute I finished the water he asked me to go leave a urine sample and then I can leave. I was never again checked on or even made sure I was okay to drive. I had someone else come to pick me up because I did not feel that it was a safe decision for me to drive.

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 paid for both blood tests from those dates. The fact that Sonora called my doctor, doesnt mean that Sonora performed my blood tests. The test in March, YES. The test in June, NO. That was completed by blood test company in [redacted]. Sonora double billed me. And, I spoke to Sonora Quest in October and they said it would be closed. I am not paying twice for the same blood test, and this is an ongoing problem for Sonora Quest with 25 Collection/Billing complaints. My company has 0 Revdex.com complaints, so their investigation is supposed to be supreme when they have proven in the past to have a consistent billing problem?

Regards,

ID#: [redacted]

 [redacted]

 

Dear Ms. [redacted]

 

Thank you for notifying us of Mr. [redacted]rsquo; concern. We have investigated the issue...

and identified the following information.

Mr. [redacted] four concerns raised in his letter to the Revdex.com include:

 
 The time of collection on his report was incorrect.

The fact that he was fasting was not indicated on the report.

He made a request for a corrected report and to have the corrected report sent to both him and his physician on November 20th, 2013 and the reports were not received.

He made a second request for a corrected report and did not receive it.
The order in question was performed at one of our Patient Service Centers (PSC) November 7th, 2013.  Based on the testing requested, Mr. [redacted]’ order was created using a process called “field accessioning”.  The field accessioning process applies the time the patient’s lab order is entered into our computer system by our PSC employee as the time of collection for the specimen. There may be a slight delay between the time the patient’s order is entered into the computer and when the patient is actually drawn.  We understand Mr. [redacted] concern regarding the differences he noted in the time he had his blood collected and the time of collection included on the report and want to assure him that this difference in time would not affect the results of the tests that were ordered.  Some tests may require an exact time of collection and in those circumstances the field accessioning process is not used.

The fact that the patient was fasting was not entered at the PSC.  I have provided this information to the PSC leadership to make them aware of the issue.

On November 20th, 2013 Mr. [redacted] contacted our laboratory and spoke with one of our Client Services Representatives (CSR) to request that the fasting status and time of collection information be corrected on his lab report.  The CSR did not complete Mr. [redacted] request to send the corrected report to Mr. [redacted] or his physician.

After not receiving the corrected report, Mr. [redacted] called us again on November 26, 2013.  Again, the CSR did not complete the task that was requested by Mr. [redacted]

The CSRs involved in this incident were brought to me for counseling on the matter.  We reinforced our Company Mission, Vision and Values to each of them.

 We sincerely apologize to Mr. [redacted] for not meeting his expectations and for any inconveniences this issue has caused him or his physician.

Mr. [redacted] will be contacted by our Client Services Supervisor to have his blood re-drawn and the testing ordered by his physician to be re-run at no cost to him or his insurance company.

 

Best regards,

[redacted] | Division Manager Support Operations – Client Services/Logistics/Specimen Management

Sonora Quest Laboratories/Laboratory Sciences of Arizona

March 9, 2015Revdex.com4428 N. 12th StreetPhoenix, AZ 85015-4585Attn:  Dispute Resolution ConsultantRE: Complain ID #[redacted]Dear Dispute Resolution Consultant:It is unfortunate that our response was not satisfactory.   As we have explained previously, Ms. [redacted] insurance processed her claim leaving her patient responsibility of $66.39.  The statement Ms. [redacted] received shows the amount that was written of our system to the collection agency.  When an account is sent to collections, it is no longer in our system.  The amount on the statements with a COL write off is patient responsibility. We have sent another statement  showing the balance. We will offer Ms. [redacted] a discount of 20% making her patient responsibility $53.11.  She may contact our customer service department at ###-###-#### to make the payment for account [redacted].Sincerely[redacted] Billing Customer Service Supervisor

We understand your frustration regarding access to your lab results. The [redacted] by [redacted] mobile app for lab results is available through one of our parent companies, [redacted], who also supports this product. In our research of this issue, we understand that both [redacted]...

[redacted] and our local Release of Information Department have corresponded with you directly via email to attempt and resolve this issue. Please note that your Arizona [redacted] account should be used to access lab results performed in Arizona. You can reach us locally by email at  [redacted] for further assistance.Thank you for your patience as we work together to resolve this issue.[redacted]HIPAA Privacy/Release of Information Director [redacted]

We came home from vacation to find two phone messages from RSI saying they were calling about a debt. Since we don’t owe anyone anything we ignored it thinking it was a scam like the TV news was warning everyone about. A couple days later RSI called and told me I had an unpaid bill with my doctor. Every time I saw that doctor I paid so I didn’t think I owned anything. I called the doctor’s office and they told me I owed nothing. They thought it might be the lab bill. I found the page with the lab results and called lab name on the top of the page. They told me that I didn’t owe them anything. I then call RSI back at 888-480-1576. This time they told me the truth that the bill was from Sonora Quest Laboratories. This surprised me because I use Sonora Quest Lab services all the time and have an account set up with them. RSI also said they would send me a copy of the bill. I went on line to Sonora Quest’s website to see what was going on. I couldn’t find any balance due and they had my address correct, they had my email address correct and my phone number correct. The service date was 12/17/15 and with all my information correct I had never received a bill from them, which is not unusual since Medicare and my insurance usually pays everything. At the time on 12/17/15 they told me if I paid at the time of service I would receive a discount so I gave them my credit card number and my mailing address even though they already had it. Yesterday, 7/27/16, after I talked to the lady at Sonora Quest she emailed a copy of the bill. The bill she emailed had our street address on it instead of the P O Box. How they got the street address I don’t know because we don’t give that out unless we are having something delivered UPS or FedEx or they absolutely insist they have the street address. There is no mail delivery where we live, everyone has to have a P O Box. This is why we never got a bill and Sonora Quest didn’t bother to look at my account to see the P O Box or my email address that they use all the time to send me emails or call the phone number that they have. Instead they turn the bill over to a collection agency and collection agency calls us because of Sonora Quest’s incompetence. Today I received the bill from RSI, after a week. They put me thru hell over this. They should be paying me for what they put me thru. If they are that incompetent about their billing and account information can there lab results be trusted?

Dear Dispute Resolution Consultant,

I have attempted to work with Sonora Quest in good faith and to simplify matters, and did, as Mr. G[redacted] stated, attempt to get my insurance to negotiate the cost of the test, as suggested by Sonora Quest. As all three attempts were denied, the only solution I have for Sonora Quest is to either lower the price of the test to a standard "allowed" insurance amount, which I will possibly consider paying to help them cover their costs, or remove the charges completely. As Mr. G[redacted] stated in his reply, Sonora Quest has a signed letter of attestation from my provider that informed consent would be obtained, not a letter or signed consent from me. I was never consented by my provider, was not notified of the test by my provider, nor was I consented or notified by Sonora Quest. If Sonora Quest has a letter from my provider, then they need to approach them to recover costs, not myself. My provider does not financially speak for me and has no legal power to commit me to any financial agreement. If Sonora Quest failed to notify me to assure that I was in agreement with all tests and associated costs before testing was completed, that is not my fault and indicates that a change is needed in their patient check-in procedure to ensure that this oversight is not repeated. Assuming that any written order is a consent to perform and charge for labs is an very questionable business practice given that incorrect orders (such as this) can easily be written, or that they can be written on the wrong patient. Holding the patient financially responsible for your agreement with the writing providers is highly unethical and not legally binding in any way. If your written agreement is with the provider, you need to hold them financially responsible for their mistakes, not the patient.

Sincerely,

May 27, 2016Revdex.com of Southern Arizona5151 E. Broadway Blvd #100Tucson, AZ 85711Attn:  Valerie Ramos RE: Complaint ID #[redacted]- [redacted]Dear Dispute Resolution Consultant:Thank you for your correspondence and for providing us an opportunity to investigate and respond to Ms. [redacted].  We apologize our initial response did not satisfy Mrs. [redacted]’s concern.Mrs. [redacted] communicated in her response that her provider has no legal power to commit her to any financial agreement. Sonora Quest has received from her provider’s office the financial agreement that she signed on 06/17/2015 acknowledging that Mrs. [redacted] is financially responsible for services render by Banner Health or providers affiliated with Banner Health. Sonora Quest Laboratories has met the established guidelines and is a Banner Health affiliate. We have reached out to the physician’s office to discuss resolution in an attempt to help and address Mrs. [redacted]’s concern. As a one time courtesy and goodwill effort to assist Mrs. [redacted] with resolving her account balance, her ordering physician’s office has agreed to pay Mrs. [redacted]’s balance in full. Sonora Quest Laboratories now considers Mrs. [redacted]’s matter resolved.We hope this addresses Mrs. [redacted]’s concerns. Please contact me directly with any additional questions.Sincerely,Andrew D[redacted]Andrew D[redacted]Billing Customer Service Assistant SupervisorSonora Quest Laboratories

We apologize that Ms. [redacted] is not satisfied with our response.  As we have explained previously, her insurance processed her claim leaving her patient responsibility of $58.73.  We are not over charging but billing for what her insurance states is her patient responsibility.  As a courtesy we sent an appeal to her insurance when the physician provided all the necessary information to do the appeal.As a result our courtesy appeal, Ms. [redacted] insurance reprocessed her claim and paid the balance on 01/30/2014, leaving no patient responsibility.  Ms. [redacted] account balance is now zero. Sincerely,[redacted]

Dear: Ms. [redacted] Thank you for your correspondence and for providing us an opportunity to investigate and respond to Ms. [redacted] concerns. Sonora Quest Laboratories does collect past due balances when patients present for new laboratory services.  The laboratory staff...

on site does ask for past due balances.  Addressing past due balances is not a HIPAA violation.   Ms. [redacted] had laboratory services on 9/25/2012.  Both claims were submitted to Medicare.  [redacted] denied the claims stating “Care may be covered by another payer”.  Several letters and statements were sent to Ms. [redacted] at the same address provided in this complaint.  We didn’t receive any returned mail and we didn’t receive any response from Ms. [redacted].  If Ms. [redacted] has questions on these bills she can contact our Customer Service Department to discuss at ###-###-####.   We apologize if Ms. [redacted] felt intimidated because of the stature of the employee that provided services to her.   We are EEOC compliant and do not discriminate when hiring.  We hope this addresses Ms. Seeger’s concerns.  Sincerely  [redacted]Customer Service SupervisorSonora Quest Laboratories