Can the secondary insurance provider deny a claim that was not filed with the primary insurance provider first?

already exists.

Would you like to merge this question into it?

already exists as an alternate of this question.

Would you like to make it the primary and merge this question into it?

exists and is an alternate of .

Answer Let me tell you what happend to me. I hope that this helps. I used to be covered by two insurance companies. My primary insurance company was through the company that I worked with. My secondary was with the company that my husband works with. When a claim was filed with my secondary insurance company they wanted to know how much my primary insurance company paid for and until then they would not pay anything. So I had to submit to my primary insurance company and once they paid some then the secondary would. I hope that this helped:)
Yes. A claim must always be made with the primary insurer first.
30 people found this useful

Can secondary insurance pay claims that are denied by Medicare?

That would be covered under the terms of your policy. In general that is what supplemental, (secondary) insurance is primarily for. Most "supplemental" plans pay the 20% that Medicare didn't pay only AFTER seeing an "explanation of benefits" statement--i.e. proof that Medicare paid their part. If M (MORE)

With Primary and Secondary Insurance your primary denied your claim because it was over a year is your secondary obligated to pay?

Answer . Yes, subject to the limits in their policy.. Answer . No. With most insurance policies, there is what is called a timely filing limitation. For my company; contracted providers have 6 months, and non-contracted providers have 12 months to submit the claim. If your primary insurance r (MORE)

If a medical claim is denied because the provider did not file in time is the patient responsible for payment?

Check out this page where Medicare talks about providers being responsible for billing errors if it's their fault http://www.cms.hhs.gov/manuals/13_int/a3700.asp CA Civil Code # 3517. No one can take advantage of his own wrong. 3520. No one should suffer by the act of another. 3526. No man is respon (MORE)

If you have insurance through two current employers and the primary is an HMO can you decide to select a provider from the secondary PPO?

IMHO Yes CA Insurance Code 10270.98, but you would only get paid from the HMO Group disability (Health Insurance) policies may provide, among other things, that the benefits payable there under are subject to reduction if the individual insured has any other coverage (other than individual policies (MORE)

Are health care providers obligated to accept payment from a secondary insurance at their fee schedule when the provider does not participate with the the patient's primary insurance?

Answer . \nIt has been my experience that providers of health care are not obligated to accept secondary or even primary insurnace coverages if they are not under contract with that insurance company. I believe they are free to accept no insurance coverage at all and demand "cash" up front if th (MORE)

Can you designate which of your insurance is secondary and which is primary?

Secondary medical insurance is a second level of insurance coverage. Under most circumstances, the two policies are independent of each other. One policy may pay for a service while the other may not. The primary policy must pay first, then the secondary. The choice of which policy is primary or sec (MORE)

What is the statute of limitations for suing an insurance provider for denying a homeowner's claim?

Answer . States establish SOL's concerning any type of lawsuit other than one that would come under federal jurisdiction. The statute of limitations will vary from state to state - check local law. Every claim should be made as soon as possible after the event, however, to preserve evidence of yo (MORE)

Are health care providers obligated to accept payment from a secondary insurance with whom they participate when the provider does not participate with the patient's primary insurance?

Yes they will have to accept payment from the secondary insurance, however they will have to bill the primary provider first.. What ever the primary insurance does not cover should be covered by the secondary insurance.. However, it will depend on the service being provided and the contracted amou (MORE)

Primary and secondary health insurance?

You could have two insurance companies pay the same medical bill or claim for a date of service through a process of subrogation where the first insurance company determined by the effective date of coverage will pay their portion of the bill and the second insurance company will pay the balance. Th (MORE)

When you have a primary and secondary insurance will the co-pay from your primary insurance be paid by the secondary insurance?

I have insurance paid for by my employer (primary) and through my husband's employer (secondary). In my experience, I have never had to pay the copay required by my primary because it is covered by my secondary. When I first got married, 2 years ago, I still paid the copay, but the doctor's office w (MORE)

Can a Medicare provider bill a secondary insurance for the Medicare deductible?

This is directly from the Medicare and You 2009 Book:. When you have other insurance, there are rules that decide whether Medicare or your other insurance pays first. The insurance that pays first is called the "primary payer" and pays up to the limits of its coverage. The one that pays second, cal (MORE)

What is primary and secondary dental insurance?

If a husband and wife both have dental insurance through their employers, the employee's insurance is primary when the employee is the patient, and it must pay it's benefits. The spouse's insurance is secondary, and will only pay once the primary insurance has paid. Depending on how the policy is wr (MORE)

How do you file a life insurance claim?

Call the insurance company and tell the representative that you want to file a claim. You will be given instructions. You will have to complete a claim form that the insurer provides, and at a minimum, submit a certified copy of the death certificate. The insurer may or may not conduct a further inv (MORE)

If a person has two Medical insurances and the primary denies due to preexisting will the secondary pay?

It depends on a few things. If your primary insurance is say less than 2 years old, they can deny claims to determine whether the condition is pre-existing. If you have had the secondary policy longer/ or the pre-x period has already been satisfied, then they may pay the claim as secondary. As long (MORE)

How are primary and secondary insurance determined?

It is usually written in an insurance policy if the policy is primary or secondary. If both policies have language that makes them secondary if other insurance is present then they may split the amount owed. State laws may change this.

Is it necessary to provide current insurance to the new insurance provider?

Generally Yes. Many insurers will decline your application if you can not prove that you have not had a lapse in coverage. If the new Insurer issued you a policy with the stipulation that you would provide them a copy of your current or previous policy at a later time. They can also cancel your p (MORE)

Does Johnson Insurance provide life insurance?

Yes, Johnson Insurance provides options for individual life insurance policies. When you first sign-up, you have the option to choose an immediate issue or fully underwritten policy, then later you may choose between a term-life or whole life policy.

Does Zurich Insurance provide auto insurance?

Yes, Zurich insurance does provide auto insurance. The information can by found on the Zurich Insurance web page. They also provide many other forms of insurance including life insurance and homeowners insurance.

Does Campervan Insurance provide life insurance?

In researching this I was unable to come up with any insurance company that was named Campervan insurance. There are many others that provide comprehensive insurance services but CamperVan is not one of them.

What kind of insurance does Willis Insurance provide?

"Willis Insurance provides multiple options of insurance: home, auto, life, health, business, disability, long term care, medigap, annuity insurance. There website is simple. Enter your zipcode and what insurance your after, hit enter and recieve a quote."

Does a medical provider have to take a secondary insurances' write off?

It depends. The first question to be answered is whether the medical provider has negotiated a contract with that insurance company. If not, then the secondary is responsible for 100% of the balance left by the primary--no adjustments allowed. The entire balance must be paid by either the insurance (MORE)

Is it legal for a dental insurance company to deny coverage as a secondary provider?

Yes, it can be and no it may not be. You did not give enough information for a determination. Usually, the primary carrier pays their maximum, then the secondary carrier pays some or all of the portion of the procedure that is left BUT not more than the claim itself or more than they would have pa (MORE)

Where do you go to file a complaint on a health insurance provider?

If it is a group health insurance plan -- through your employer -- go to your HR person or your manager. They can get in touch with the insurance broker who sold them the plan. If it is an individual plan -- one you bought on your own -- go to the broker who sold it to you. Failing either of tho (MORE)

Will your insurance be primary for your children even though your ex-husband provided insurance first and the decree states he has to provide the insurance?

Yes, it is possible that your insurance will pay before your ex-husband's no matter what the divorce decree states. Most insurers use what is called the "birthday rule". The plan of the parent whose birthday occurs first in the calendar year is considered the primary (or first) payer for the child (MORE)

What kind of insurance is provided by Admiral Insurance?

Admiral Insurance is part of the Admiral Group and is a car insurance company. Admiral insurance mostly focuses on younger clients who traditionally would have higher premiums on car insurance. They also mostly focus on the area of London, Southeast England, and Scotland.

What are examples of small claims from the health insurance provider?

An example of a case against a health insurance provider is the death of a child following a doctor incorrectly prescribing a surgery. The small claims case is attempting to pay for the costs of the visitation of a infertility clinic and the birth of another child equaling $7200 dollars.

Are primary and secondary insurance claims are filed simultaneously to ensure prompt payment to the medical practice?

In general this is true. However, the insurance policies usuallyhave "coordination of benefits" provisions which explain whichpolicy pays first and under what circumstances. There are sometimesalso statutes (laws) that dictate the order of payment. A goodexample of this is when one is injured in an (MORE)