Author Topic: Billing Pt. Responsibility Amount when primary insurance denies/Timely Filing  (Read 2203 times)


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Hi There,

Fairly new to billing for private physicians.

Patient has primary and secondary insurance. In network for both. I submitted a claim to primary insurance - Aetna - and it returned denied for timely filing. Sent claim to Medicare as secondary and ERA returned stating patient responsibility was $18.89.  I want to confirm the patient should be billed for 18.89.   

Thanks for you input.


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This is a tricky question because due to the timely filing denial by Aetna you should not charge the patient, however, with the patient having Medicare secondary and they did make patient, Medicare is stating you can bill the patient the $18.89.  So I believe that you can bill the patient the $18.89 based on the Medicare payment.
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Yes, you can bill to patient.