Secondary Claims

[bsmedbilling]

Hi everyone,

I'm reviewing a claim where the patient has primary Medicare coverage and the secondary coverage is United Healthcare (Supplemental). The EOB for UHC states that the coinsurance amount is $26.42. Can I attempt to collect this amount from the patient if they have Medicare coverage?

Thanks,
Bsmedbilling

[DMK]

Absolutely.  Usually a secondary picks up deductibles and co-pays.  Some of them even cover items Medicare doesn't.  We're finding more and more secondary policies have deductibles and co-pays as well.  You are obligated to collect whatever co-pay or deductible there is from the patient.

[bsmedbilling]

Thank you so much for your help!

Bsmedbilling

[dekenn]

you can collect as long as the medicare eob has it as patient balance also.
If the Medicare eob shows less than the 26.42 as patient balance, you cannot bill the patient for the whole thing.