Out-of-Network Claim Form

Submit claims for providers outside the Quest network

To submit claims for providers outside the Quest network, download and complete the Out-of-Network Claim Form. Submit the completed form, along with the itemized bill from the provider, to Quest:

  • Mail
      Quest Behavioral Health
      Attn: Claims Department
      PO Box 1032
      York, PA 17405

  • Fax
      717-851-1414
      Attn: Claims Department

Instructions for Submitting Out-of-Network Claims

For questions, please call Quest Claims Department at 800-364-6352 or 717-851-1480.