Author Topic: Should I pay copay secondary insurance  (Read 1263 times)

quentine

  • Newbie
  • *
  • Posts: 2
Should I pay copay secondary insurance
« 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.

PMRNC

  • Hero Member
  • *****
  • Posts: 4254
    • One Stop Resources & Networking for Medical Billers
Re: Should I pay copay secondary insurance
« Reply #1 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.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

quentine

  • Newbie
  • *
  • Posts: 2
Re: Should I pay copay secondary insurance
« Reply #2 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.

kristin

  • Sr. Member
  • ****
  • Posts: 493
Re: Should I pay copay secondary insurance
« Reply #3 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.