Medical Billing Forum
Billing => Billing => : pweinstein November 10, 2008, 03:47:08 PM
-
Can anyone give me an answer to this one?
When a patient has a comp case that is only 50% covered by workers comp and the rest of the claim is 50% covered by say INDEPENDENT HEALTH INS. Does the insurance company (Independent Health) pay at their contracted rate at 50% or the 50% of the comp rate? I am billing in New York if that makes a difference.
-
We are in NY as well and have had a few of these cases. The workers' comp claim is submitted first, then you submit to the secondary with a copy of the comp eob. The secondary, or major medical insurance carrier pays on the 50% of the comp fees, not on their own fee schedule.
Michele