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CALI:
I have a request from a pt who wishes I fax claims to her so she can submit to another insurance company that I am unaware of; I have previously billed Anthem & have rec'd payment leaving a $20 copay; my concern is that the second insurance will pay the allowed amount directly to the doctor which will create an overpayment; is there a way I can avoid this? do I refund the pt the difference?
Thank you,

DMK:
We have several patients who self bill their secondary insurance.  Usually the secondary only picks up the deductible, or co-pay leftover from the primary.  If the secondary pays more than the primary's allowed amount, it shouldn't be a problem to adjust the write off.

PMRNC:

--- Quote ---I have a request from a pt who wishes I fax claims to her so she can submit to another insurance company that I am unaware of; I have previously billed Anthem & have rec'd payment leaving a $20 copay; my concern is that the second insurance will pay the allowed amount directly to the doctor which will create an overpayment; is there a way I can avoid this? do I refund the pt the difference?
--- End quote ---

I agree with DMK, only I will add that you can do a secondary claim w/out an assignment if you don't want to deal with the write/off (unless it's BCBS). Also a mini note.. I won't FAX PHI or any thing unless the patient completes another authorization which includes permission to fax to the number specified. I work with a lot of mental health providers and you'd be surprised at what length the x spouses or non custodial parent's will go to in order to get information. I require a special permission authorization which has the fax number, the patient or custodial parent's signature and it's a ONE time auth for specified information. C Y A

CALI:
Thank you; my concern is that there will be a credit balance after the secondary pays and I adjust the insurance write off; do I send the pt the credit?

DMK:
No, you would adjust the write off in your system.  It's technically not an overpayment if the secondary pays more than the primary.

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