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:
- Quest Behavioral Health
- Attn: Claims Department
- PO Box 1032
- York, PA 17405
- Fax
- 717-851-1414
- Attn: Claims Department
For questions, please call Quest Claims Department at 800-364-6352 or 717-851-1480.