Frequently Asked Questions
Do services need to be pre-authorized / pre-certified?
All services need to be precertified with Quest. Precertification can be completed during a brief telephone contact (1-800-364-6352) with a care manager.
Do members need a referral from their Primary Care Physician?
Members do not need a referral from their PCP. Quest encourages ongoing communication between the behavioral health provider and the member's PCP to facilitate coordination of care.
How do I find out if my provider is in the Quest Provider network?
Members may contact Quest to determine if their provider is in the
network or for a referral to a network provider.
What if I want to see someone not in the Quest Provider network?
If the members benefit plan has an out-of-network benefit the member may see a licensed provider; precertification is still required. Reimbursement will be based on Quest's established rates. Out-of-network providers are not obligated to accept the Quest rate as payment in full, which can result in a higher out-of-pocket expense. Some plans do not have out-of-network benefits.
How do I find out my benefits?
Members may contact Quest directly for benefit information. Any of our clinical and customer service team can assist you. If Quest is not the benefit administrator members will be referred to the appropriate organization. Benefit exclusions can be found in your benefit handbook.
How do I submit a claim?
Most network providers will submit claims on your behalf. Claims should be submitted directly to the benefit's claims processor. If Quest is the claim's processor, a standard HCFA or UB-90 form can be used. They should be sent to: P.O. Box 1032, York, PA 17405-1032.
How do I contact Quest if I have questions regarding a claim?
Members may contact our business office toll-free at 800-364-6352, e-mail us at claims@questbh.com, or write us at our above address.
What if Quest is the secondary insurance?
If Quest is the secondary insurance you are required to stay within the boundaries of the primary insurance. Services are must still be precertified by Quest. Quest requires an EOB (explanation of benefits) from the primary insurance to be able to process the claims.
