Payments > Patient Billing

Primary and secondary ins allowance

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cmpas:
Hello ,
I need some help on a issue.  patient has 2 insurance and our office participate in both ins and both ins has different allowed amount. If primary allowed amount is more than the sec allowed amount it brings down the patient responsible  as per sec ins. Can I just adjust for pri ins and bill the patient for the leftover after sec ins payment which would be more than what sec eob states as patient responsible.
Or should I also adjust the sec ins and bill only what sec ins eob states as pt responsible.
Hopefully someone understood my question and looking forward for an answer. Thank you.

Merry:
I would think that you have to adjust per the secondary as you are contracted with both. Any other responses?

cmpas:
Thank you Merry for your response. I have read in a different blog that we can bill whichever ins has higher allowed amount since we are contracted with both ins. I wasn't sure about it ,that's why I asked my question.
To my general opinion ,since we billing sec for the pt responsible amount from pri ,we should be allowed to bill the patient for rest of the amount after sec pays.
Ex. as per pri pt is responsible for $50. we bill sec ins for that amount
sec says $30 is allowed amount and went to ded.so pt is responsible for only $30.
Do we have to w/o the $20 from pri responsible or we can bill patient for $50.
Appreciate any response. Thank you.

PMRNC:
COB rules say you take the higher of the allowables.

cmpas:
Ok then I am sending patient bill for $50.Thank you.

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