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Medicare Primary and Secondary insurance Co-pays

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I have recently started in a independent docs office and had a question come up that I could not remember the answer to.
For a patient, Medicare is their primary insurance. They have a secondary insurance that goes with it. The patient was using the secondary ins. for the visit. Do we take a copay from the secondary or is it already covered by Medicare which is their primary? Basically what I am asking is there a copay on the secondary insurance?

I'm confused, you say they were "using" the secondary? They can't, they have to use/Bill Medicare first. Copay for secondary depends on their plan.

and on what the patient responsibility is after Medicare.

If Medicare is their primary payer, it MUST be filed first and NO I would not collect a copay from their secondary insurance.  I would bill both payers first and then bill the patient ONLY if there is a balance left.

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