We ask our clients' staff to always ask the patient if they have a secondary. But they don't always remember to do this. So we also sometimes end up with situations such as what you described. When we are informed that the patient has Mediciad as secondary, we simply write off what we billed them for (that is our agreement with our clients) and move on.
Thanks for the response. But one last question. When you billed Medicaid as secondary, did you attach a copy of the primary's EOB? We do that in California, but I don't know that all state Medicaid programs require that. It seems that attaching the primary EOB to the Medicaid billing would make it more difficult to defraud Medicaid. But that assumes the person receiving the EOB in the Medicaid office would know how to interpret what they were looking at.