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Two primary insurances

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Tracy:
I would like to know what the two insurances are and what state you live in. Aflac does not send a check to the provider they send the check to the patient so the second insurance shouldnt' be AFLAC. Also I am in Oregon and the individual plans here you cannot purcase if you are on a group insurance plan. Now we all know that when we talk to the "wonderful" employee's at the insurance companies they often don't know a darn thing. If you have an overpayment from an insurance company the insurance company is going to want a refund. DO NOT refund the patient any money if they have not paid you any. You don't want to send the patient a check and then 6 months down the road have the insurance company ask for the money back. If Primary paid oh lets say $1500.00 and wrote off $500 with a patient balance of $500 and the secondary paid $1500.00 and a write off of $500.00. You would only post the first write off and the secondary would get the refund for $1000.00.

Tracy

Michele:
Hi,

   In order to help you more I need more info.  I don't want to give you the wrong answer.  Please tell me the amount charged, the amount paid by Ins 1, the write off by Ins 1, the amount paid by Ins 2, and the write off by Ins 2. 

I would also recommend that you call Ins 2 one more time and verify that they DO NOT coordinate benefits with Ins 1 and get the first and last name of the person you're speaking with.  DOCUMENT the date and time of the call and the person's name in the patient's chart.  Advise them that you are verifying this before refunding the patient and you would like them to document your call on their end.

Also, what are the two insurances?  Group plan thru employment and what??

Thanks
Michele

kbolt:
Total charge $108.00
Group insurance Benesys paid 56.92, write-off of 44.76, leaving pt responsibility of 6.32
Individual plan thru BlueCross BlueShield- paid 49.05, showing write-off of 46.69, leaving pt resp. of 12.26

With both payments and the Benesys write-off only the credit is $42.73. If I were to enter both write-offs the credit would be 89.42. I have documented who I spoke with at both insurances when they have stated that refund should go to patient. Also, we DO coordinate with both insurances unfortunately in this case.

Thanks for helping,
Kim in Louisiana

Michele:
Wow, I have never heard of a BC plan that didn't coordinate!  That is a new one for me.  Anyway, I would definitely not apply both write offs.  I would calculate as follows:

Charge                       $108
Payment from Benesys     56.92
Write off from Benesys     44.76
____________________________
Balance                           6.32

Payment from BCBS          49.05
Keep Pt resp of                 6.32
______________________________
Send patient refund of       42.73

That is how I would do it if it were up to me, but as I had stated earlier, I would make sure I had the name of the person that advised me from BCBS that they DO NOT coordinate with Benesys.

Good luck
Michele

kbolt:
Thanks so much for your advice!

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