Dealing with Primary and Secondary Insurance Writeoffs/Payments

[Qualls14]

I have a question regarding what to do when a secondary insurance pays more than the remaining balance on the claim (after primary insurance has paid).  Example: Bill is $100.  Hypothetically, we will say BCBS pays $20 & asks us to write off $50 leaving a $30 balance.  Well then lets say we bill the Seconday correctly same claim with copy of primary BCBS eob.  Then the Secondary, Cigna comes back and pays $35.  Can you reverse the primary writeoff to balance out the patient's bill/account?  Or is this truely considered an overpayment and must refund the secondary?

[PMRNC]

Assuming you are par with both you write off the balance of the plan with the higher allowable.  NOW keep in mind that some secondaries are private or supplemental plans insureds pay for out of pocket, many seniors are "over" insured, this CAN mean the patient will get back MORE from a visit and it's perfectly legal because they are paying the premiums on that supplemental or private plan.

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