private healthcare cover nonsense (blood tests)

Bodo

hi, my story is:
- had rather extensive blood test done in gp clinic, got the receipt
- i am covered for rather expensive insurance policy (company care plus) with quinn healthcare, paying extra for this out of my own pocket too.
- blood test seems to me is a very essential medical procedure, sometimes even might be lifesaving so if other services like visits to reflexology/acupuncture/osteopathy/homeopathy specialists (sigh) are covered as outpatient costs, it would never occur to me something so essential woudn't be covered?!

- however to my surprise my claim was rejected on the basis that "procedure was performed by a nurse and not GP"

So hence my question is:
- is this a normal practice by irish health insurance providers not to cover blood tests or is it only a "Quinn-thing"? btw. my wife has no such problems with Aviva
- is it possible to have a blood test done in a way covered by private insurance (or by Quinn) somehow? what's your experience with this? When I asked Quinn they couldn't tell me (again nonsense explanation) apart from saying "get it done by GP and we will cover it", obviously there are 0.0 GPs anywhere in the world (including Ireland from what I hear) wanting to be bothered by this, they will always task their nurse with it etc. which makes me think this is intentional misinformation game by Quinn, but I need some more input on this.

Any info would be appreciated, thanks in advance!

Rgds,B.

Stark

I have the same issue with VHI. Things like blood tests, x-rays etc. not covered.

spaceHopper

Bodo wrote: »

hi, my story is:
- had rather extensive blood test done in gp clinic, got the receipt
- i am covered for rather expensive insurance policy (company care plus) with quinn healthcare, paying extra for this out of my own pocket too.
- blood test seems to me is a very essential medical procedure, sometimes even might be lifesaving so if other services like visits to reflexology/acupuncture/osteopathy/homeopathy specialists (sigh) are covered as outpatient costs, it would never occur to me something so essential woudn't be covered?!

- however to my surprise my claim was rejected on the basis that "procedure was performed by a nurse and not GP"

So hence my question is:
- is this a normal practice by irish health insurance providers not to cover blood tests or is it only a "Quinn-thing"? btw. my wife has no such problems with Aviva
- is it possible to have a blood test done in a way covered by private insurance (or by Quinn) somehow? what's your experience with this? When I asked Quinn they couldn't tell me (again nonsense explanation) apart from saying "get it done by GP and we will cover it", obviously there are 0.0 GPs anywhere in the world (including Ireland from what I hear) wanting to be bothered by this, they will always task their nurse with it etc. which makes me think this is intentional misinformation game by Quinn, but I need some more input on this.

Any info would be appreciated, thanks in advance!

Rgds,B.

Resubmit it in writing telling them it was their mistake as the test was ordered by the doctor, get them to write back with a reason for refusing it and make a complaint the the HSE and www.financialombudsman.ie they will give in.

broker2008

You are all on the wrong policies if you don't get a payout from vhi and quinn.Aviva do pay out.

It must be the way the receipt has been issued for them to know it was a nurse that took the blood. I have looked at their website and can't find anything that says it has to be a doctor. I think it should be payable.

VHI should pay out, what policy are you on that doesn't?

cookie1977

Blood tests are normally free when order by a GP and taken in a hospital. Why did the GP/Nurse perform it? I presume they still sent the sample to a hospital to be tested. Very odd.

Bodo

Hey,

thx for the feedback so far. spaceHopper was completely right saying tests were ordered by the doctor. Story was:
- consultant wrote a letter to my GP asking for tests to be performed (according to him "tests-in-hospital" option would cost 2-3x more, so even with 50% refund from quinn I would be hammered)
- coming with the letter from consultant to the GP clinic they told me I can just go straight for the test and that would be all
- tests were sent by GP clinic to Lablink http://lablink.ie, which then provided full report to my GP, which was then provided to me

There is nothing odd in it - if there is a facility in the GP clinic to take the blood sample and send it to the lab, then nobody should be bothered to send me to hospital instead, makes it covenient for me. but cookie1977 is right, if GP's office is "one-person-shop" then they would probably send to hospital, but then I wonder again about the cost of it and possible refund amount.

anyway the response from Quinn doesn't make sense, there was a valid medical need and medical test was performed, imho this should be enough. I think spaceHopper's advice was very good, I am going to test it next I think :-) Thx a lot!

feel free to further post any comments/experiences/observations you made with this, thx!
Rgds,B

NuMarvel

spaceHopper wrote: »

Resubmit it in writing telling them it was their mistake as the test was ordered by the doctor, get them to write back with a reason for refusing it and make a complaint the the HSE and www.financialombudsman.ie they will give in.

FYI, the HSE aren't party to this, as it's a health service performed by a private provider.

And in order to make a complaint to the Financial Services Ombudsman, you need to first go through the insurance company's complaints process; it's not just a case of going straight to the Ombudsman. The Ombudsman's process will be on their website.

Bodo

sure, I meant following only (first) part of the advice, at least as (first) next step :-)

broker2008

I looked into this today and you are right. There are other instances of where Quinn didn't pay for blood test. The reason was that a nurse is signing the receipt as a nurse as opposed to just signing it for and on behalf of abc lab.

Ms_Opinionated

Outpatient blood tests are claimable for a benefit when carried out by a GP, not covered when carried out by a nurse. This is more than likely in the t+c's that we never read!!!!! Anything done on an outpatient basis, whether it be blood test, ct scans, x-rays, etc will only ever give you a small benefit subject to an excess. They would never be fully covered.

Bodo

Outpatient blood tests are claimable for a benefit when carried out by a GP, not covered when carried out by a nurse

that's why I mean this is nonsense and if insurer will keep on throwing explanations/T&Cs like this on me, then i will find a different one. as no gp in this country or probably anywhere in the world carries out such procedures, this is a very convenient formulation for Quinn, right?

This is more than likely in the t+c's that we never read!!!!!

and why is that? maybe I would read them, if sbd really cared to provide them to me instead of 5page summary booklet that doesnt explain anything. again very convenient.

Anything done on an outpatient basis, whether it be blood test, ct scans, x-rays, etc will only ever give you a small benefit subject to an excess

that "very small" amount is over 100€ in my case. pocket money! :-)

CCFROM

Hi There

Unfortunately Quinn Healthcare do not cover any treatment carried out by a Nurse, your benefit is 75% of the GP visit. You are also covered in full for certain procedures carried out in a GP surgery.

It is a bit odd that GPs all over Ireland charges for blood tests as the HSE does the blood tests free of charge. This is the reason why no health insurer covers it.

You have 50%/75% cover outpatient pathology tests once they are carried out in a participating centre.

BTW Lablink is not a participating centre with Quinn Healthcare

Bodo wrote: »

hi, my story is:
- had rather extensive blood test done in gp clinic, got the receipt
- i am covered for rather expensive insurance policy (company care plus) with quinn healthcare, paying extra for this out of my own pocket too.
- blood test seems to me is a very essential medical procedure, sometimes even might be lifesaving so if other services like visits to reflexology/acupuncture/osteopathy/homeopathy specialists (sigh) are covered as outpatient costs, it would never occur to me something so essential woudn't be covered?!

- however to my surprise my claim was rejected on the basis that "procedure was performed by a nurse and not GP"

So hence my question is:
- is this a normal practice by irish health insurance providers not to cover blood tests or is it only a "Quinn-thing"? btw. my wife has no such problems with Aviva
- is it possible to have a blood test done in a way covered by private insurance (or by Quinn) somehow? what's your experience with this? When I asked Quinn they couldn't tell me (again nonsense explanation) apart from saying "get it done by GP and we will cover it", obviously there are 0.0 GPs anywhere in the world (including Ireland from what I hear) wanting to be bothered by this, they will always task their nurse with it etc. which makes me think this is intentional misinformation game by Quinn, but I need some more input on this.

Any info would be appreciated, thanks in advance!

Rgds,B.

Bodo

CCFROM wrote: »

Hi There
It is a bit odd that GPs all over Ireland charges for blood tests as the HSE does the blood tests free of charge.

could you explain this further? How can I get GP or consultant to refer me for HSE made blood test? I assume they would be insisting to have it done onsite/lablink, but can they deny me to be referred? also would I be struck by long waiting periods? or any other problems with this?

just read/noticed - HSE does them for free, but for medical card owners only (so it doesn't include me, i am a rich b***ard :-) ). Is that what you meant?

You have 50%/75% cover outpatient pathology tests once they are carried out in a participating centre. BTW Lablink is not a participating centre with Quinn Healthcare

and this is very useful info! I was asking Quinn's customer care about exactly this (incl participating centers) to which they told me "they can not recommend me anybody for competitive reasons blahblah". Could you give me some names/recommendations for Dublin (D7/15)? Or a general way so that I can look it up myself?

Sorry if anything seems obvious. I really have to ask as this is completely all new to me and thanks in advance for your response!

Teagwee

I'm confused here Can anyone confirm the situation re Quinn and blood tests taken by a nurse in a GP clinic (not any kind of treatment)?
In my GPs surgery, a nurse phlebotomist always takes blood for testing and there is a separate €30 charge for this. Is this claimable from Quinn? Company Care Choice is the name of my particular policy but I imagine it's an across the board ruling. I only changed to Quinn last year, on my way down to abandoning health insurance altogether because of the cost.