Author Topic: Patient Balance with COB  (Read 47 times)

Gayle33

  • Newbie
  • *
  • Posts: 9
Patient Balance with COB
« on: July 21, 2021, 06:52:57 PM »
Hello I'm looking for clarification on posting COB claims.  If we participate with both primary & secondary ins. is there still only 1 adjustment/write off?

Ex:  secondary does not pay the full patient balance from the primary, can we balance bill the patient for the remaining amount they would have paid ?
I've noticed some secondary plans do not pay the full patient balance and then apply an adjustment leaving no patient resp. If this is the case then we are getting less payment for a claim than if they only had the primary plan.  I've always thought we apply the primary adjustment and if the secondary does not pay the full patient balance then we bill the patient for the remaining balance with no additional write off.  Which is correct ?

Any input would be appreciated, Thank you.       

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 5813
    • Solutions Medical Billing
Re: Patient Balance with COB
« Reply #1 on: July 22, 2021, 02:59:31 PM »
This is a tough one.  But since you are in network with the secondary, if they are saying there is no patient responsibility you would be violating the contract with them if you bill the patient, even if the primary says you can.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

Gayle33

  • Newbie
  • *
  • Posts: 9
Re: Patient Balance with COB
« Reply #2 on: July 27, 2021, 05:25:45 PM »
Thank you, I appreciate the information.

Medical Billing Forum

Re: Patient Balance with COB
« Reply #2 on: July 27, 2021, 05:25:45 PM »