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Paid by two insurances as Secondary

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tzdermpath:
I am from an independent laboratory, we do not see actual patients but receive specimens from all over the US. We often receive incomplete or wrong information but are at the mercy of what is given to us. We have quite a few patients that have Medicare as primary and then we won't receive the secondary information but it is forwarded by Medicare. Sometimes we get paid by two supplemental insurances and we are unsure who is the actual supplemental. How should we be handling these patients accounts?  Can anyone point me to a good website or information portal that will help guide me with this. We are in the state of OH but deal with patients in over 32 states.

I need a sample letter to send to those supplemental insurances so we can attempt to find out who the money belongs to.

Thank you in advance for any help!

rdmoore2003:
I would contact the provider that sent the information to you.  If that doesnt work, contact Medicare (or whatever Primary). 

rdmoore2003:
also, do you have any contracts with these referrals (providers, facilities, etc)?  I used to work for an urgent care facility, we had contract with lab for these kinds of issues.

Michele:
Most Medicare carriers have websites now.  Usually insurance info can be verified on the website.  That may be helpful.  As for a letter, I would write up one and use that as your template.

tzdermpath:
Thank you  for replying. Unfortunately I am in a sticky situation with being a laboratory who receives info from numerous offices. Some offices are great at providing patient  information sheets but some will not take the time to do it and upper management is unwilling to force the issue. We also receive outdated information all the time. We have had situations where the patient has not lived at that address or has not have that insurance for many years, therefore this makes it hard too.

Almost all of our situations are secondary insurances after medicare. Medicare pays their part then we have UHC pay $20 and then BC/BS pays $20 and the account now has a credit of $20 and we don't know who to send the money back to. We will call UHC and they will say we show it correct in our records, don't send the money back. We call Bc/Bs and they say the same thing.... now what? I also need to have this conversation in writing to have proof. (UHC and Bc/BS are just example insurances, not always those two). I am hoping that someone out there can provide me with a sample letter to be able send to these insurances.

 

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