Hi, Yes as along the insurance pay what they allow normally there wont be any pt's resp. Its understood that they pay 100% of what they allow. After primary ins paid & no pt resp - I dont see any need of flipping the balance towards secondary, further I would refund the money back to the pt as well. Thanks
The secondary should be billed anyway. If the secondary allows a higher amount then they will make payment based on their allowance.Michele
Quote from: Anand on March 22, 2010, 06:22:47 AMHi, Yes as along the insurance pay what they allow normally there wont be any pt's resp. Its understood that they pay 100% of what they allow. After primary ins paid & no pt resp - I dont see any need of flipping the balance towards secondary, further I would refund the money back to the pt as well. Thanks You can't ASSume that. part of the balance may have dropped to patient's deductible and therefore is the patients responsibility. The md may be out of network with the insurance, who's to say what the scenario is. but what we do know is that if the client paid up front, the MD does owe the client at least what the primary paid. The rest would vary depending on other situations..