Medical Billing Forum

Billing => Billing => : Linda102302 June 12, 2023, 02:18:31 PM

: Coordination of benefits between medical and pharmacy benefit
: Linda102302 June 12, 2023, 02:18:31 PM

I have a patient whose primary insurance covers the medication under the medical benefit, but the secondary plan only covers it under the pharmacy plan (drug is subject to medical carve out). Would the secondary deny the claim and the patient be responsible for any co-insurance from the primary?