Payments > Patient Billing

3 Insurances

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ellie:
Hello,

I have a patient who has Medicare primary, Medicaid secondary and Mutual of Omaha. Medicare and Medicaid paid leaving a zero balance. Mutual of Omaha paid out as secondary ? What do I do with this credit ?
Thank you

PMRNC:
If the Mutual of Omaha plan is a private, non contributory plan, you would give the credit to the patient. They are over insured. The reason you give it to them is because they are paying for the premium's. Though it would seem they are gaining financially with that credit, they are not, they are paying more in premium's than needed.

rofakamd:
re 3 insurances... medicaid is always payor of last resort ins listed shb  medicare mutual of omaha then medicaid....

PMRNC:

--- Quote ---re 3 insurances... medicaid is always payor of last resort ins listed shb  medicare mutual of omaha then medicaid....
--- End quote ---

That's not necessarily true. IF that plan is a private (non contrib plan) their payment could be a credit. ALTHOUGH I sure would look into their eligibility for Medicaid by contacting Medicaid with the Omaha Mutual plan information.

tlewis:
I"m going to go out on a limb here and say that medicaid does not know about mutual of omaha. Mutual of omaha is a VERY common medicare supplement plan. I would call your medicaid office and ask if they show the patient as having Mutual of Omaha. Then give the information that you have for that insurance. If not and medicaid pays then finds out later that the patient has mutual of omaha they are going to want their money back and by then you prob won't be able to rebill mutual of omaha. Biller friend  is having this prob right now. Medicaid came back 3 yrs later stating that the patient had a primary on DOS wants their money back and it's to late to bill the primary now. She has a copy of the eligibilty page from medicaid that you are suppose to look up everytime you see a medicaid patient  that does not show a primary, but they are still going to want their money back, She will prob be able to bill the patient but I highly doubt she will ever see any money for this.

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