Medical Billing Forum

Billing => Billing => Topic started by: quentine on June 17, 2015, 12:18:29 PM

Title: Should I pay copay secondary insurance
Post by: quentine on June 17, 2015, 12:18:29 PM
My newborn has my wife's insurance as primary, which dose NOT need copay, and mine as second which needs copay $20.
My insurance (secondary) dose not have any deductible and coinsurance.
My question is, do I need to pay copay when the left balance filed to my insurance? My insurance company pay the left balance but needs me to pay the copay which I don't think it is correct since the primary does not need copay.
Title: Re: Should I pay copay secondary insurance
Post by: PMRNC on June 17, 2015, 05:56:38 PM
It isn't that simple. I'm assuming they use the BDay rule to determine your wife as primary on the baby?

The secondary has 3 options on how it handles COB so you first want to determine the type of COB used.
Title: Re: Should I pay copay secondary insurance
Post by: quentine on June 17, 2015, 09:24:02 PM
Yes, it is based on the birthday to decide the primary.
For the COB, where I can find this information? What are those three types of COB? I check my insurance company website and find nothing about this.
Title: Re: Should I pay copay secondary insurance
Post by: kristin on June 17, 2015, 10:33:19 PM
I see this a lot with the various doctors I bill for. Patient's primary does not have copay, but rather pays a percentage, and the secondary pays the remainder, minus a copay. So, for a $100 office visit, the primary insurance pays $70. The secondary is billed. They pay $10, and put the remaining $20 as a copay, under patient responsibility. Patient is then billed for that $20 copay.