Billing

[pweinstein]

Can anyone give me an answer to this one?
When a patient has a comp case that is only 50% covered by workers comp and the rest of the claim is 50% covered by say INDEPENDENT HEALTH INS.  Does the insurance company (Independent Health) pay at their contracted  rate at 50% or the 50% of the comp rate?  I am billing in New York if that makes a difference.

[Michele]

We are in NY as well and have had a few of these cases.  The workers' comp claim is submitted first, then you submit to the secondary with a copy of the comp eob.  The secondary, or major medical insurance carrier pays on the 50% of the comp fees, not on their own fee schedule.

Michele