Medical Billing Forum

Billing => Billing => : bobjase October 19, 2022, 01:47:11 PM

: PI-xx and OA-xx | Secondary billing
: bobjase October 19, 2022, 01:47:11 PM

When we submit a bill to secondary insurance, how are we supposed to act on the Claim Adjustment Reason Groups?

For example, after billing a primary insurance, I might have something like:

• Charge: $350
  
• Provider Paid: $215
• CO-45: $70
• OA-96: $20
• PI-103: $10
• PR-2: $35

(I made up the Claim Status Reason Codes (e.g. 103), because my question is about the GROUP CODES - i.e. CO/OA/PI/PR)

If the patient has secondary insurance, I can obviously pass along the $35 PR-2, but am I also allowed/supposed to bill the secondary for the PI and OA amounts?

Meaning: Do I bill the secondary for $35? $45? $65?

Thanks in advance!