Medical Billing Forum

Billing => Billing => : gus May 15, 2010, 05:12:12 PM

: Bill Patient or a Contractual Write-off?
: gus May 15, 2010, 05:12:12 PM

You bill a charge of $197.00 and the primary (Medicare) pays $88.44, writes off $86.45 and leaves a balance of $22.11.

The secondary states the allowable is 58.18 but does not make a payment or apply anything to the patient's deductible.

I was told the 58.18 should be a contractual write-off. The explanation had something to do with one allowable being higher than the other, but I haven't been able to understand it.

Please tell me what you think should be done and explain.

Thanks!

: Re: Bill Patient or a Contractual Write-off?
: Pay_My_Claims May 15, 2010, 10:45:12 PM

sounds like a UHC secondary plan. the patient is still responsible for his 20% 

: Re: Bill Patient or a Contractual Write-off?
: Michele May 15, 2010, 11:52:34 PM

Yes, it is probably a "non duplication of benefits" plan.  The patient would be responsible for the $22.11.