Prenatal testing / insurance question
I have Blue Cross of CA / Brown and Toland and am trying to get the NIPT prenatal screening done. My midwives say the labwork can only be completed at Quest, since that's the company the state contracts with for the testing, which is supposed to be free for all californians (paid for by insurance or medi-cal). Quest and Brown & Toland say that B&T doesn't cover Quest, only Labcorp. Haven't been able to get anywhere yet with calling so thought I would ask here... Surely I'm not the only one with Brown & Toland who has tried to get the NIPT done?? Any experience /advice? Thank you in advance!
Oct 11, 2023
Parent Replies
Oh that is a GREAT question. I am currently stuck with two medium sized bills for mandated (and supposedly free) tests that were rejected by my insurance because—get this—even though the draw happened at a Labcorp (in-network)—the billing was processed by the state of CA, which is out of network. You can’t make this stuff up. Interestingly, for the NIPT I declined the free state option (which would have taken 6 weeks to process—I’d know the results AFETR the amnio, ridiculous) and opted to go direct from the company to my insurance and it was covered no problem (with results in 10 days). My advice is to insist and escalate until you get it done privately in network—there is a way to do that.
Hi! I have Blue Cross Blue Shield (Anthem) and did my genetic testing with Natera. It's still not super straightforward (I had to fight with them over billing, it's not free for all Californians because it's a different test). FWIW the California test I took in my last pregnancy was incorrect (the test isn't super accurate for some genomes).
Hello! The CA Prenatal Screening Program is contracted with both Quest and Natera. If your midwives order cfDNA at Quest through the CA PNS, the bill would come from the state Prenatal Screening Program, not from Quest. So the only thing Brown & Toland should reject would be if Quest sends them a claim for drawing your blood (the phlebotomy fee, not the actual genetic testing). Your midwives may not have the supplies on hand for ordering cfDNA through Natera.
Another commenter mentioned being stuck with bills for "mandated (and supposedly free) tests" - I wanted to mention that the State of CA does not mandate either of their two prenatal tests. It's mandatory that every pregnant person be offered the blood tests, but patients can certainly decline. The State cfDNA (aka NIPT) option does not take 6 weeks to process; in fact the result should be available within 2 weeks; however the doctors office doesn't receive the result in the SNAIL MAIL for up to 6 weeks (if the result is abnormal, then the State would call and fax the doctors office) - don't ask me why the State is sending lab results in the snail mail. The doctors office can check for the result in the online providers portal or call and request the result. It's not a good system but it's better than if results did actually take 6 weeks to process : /
The inaccurate blood test "ls2277" mentioned (biochemical serum screening) was phased out by the State Prenatal Screening Program one year ago. : )