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Does blue cross have to pay as secondary if Medicare pays for a procedure as primary?
Wiki User
∙ 12y ago
all depends on the blue cross plan you have. A lot I come by through my job as an insurance biller the secondary will pick up any copays that medicare wouldn't cover. But there is some plans that won't pay if medicare doesn't pay. So, really, yea, your secondary should pick up some cost. Unless it is just co-pays, they have the choice to make that your responsibility as a member. Do take the time to figure it out, a lot of times if you don't fight your own claims, you pay much more than you need to. Always keep and look at your explanation of benefits that you should receive from the insurances after each visit explaining what they paid and what they denied and what you owe. Anything that is not listed in the "Allowable Amount" column, you are not responsible for. Especially if the place you attended is participating with that insurance. A lot of companies try to collect for money that was denied by the insurance, but they(the insurance) states you are not responsible for.
Wiki User
∙ 12y ago
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Does blue cross have to pay as secondary if medicare pays as primary on a procedure?
Only if the procedure meets BC/BS criteria.
You want blue cross to be primary and medicare to secondary can you do that?
No. There is a federal law that requires Medicare is a secondary payer. You can find more information on the CMS website under "Medicare Secondary Payer and You."
My mother receives Blue Cross Blue Shield through a job which now pays her disability. She also is covered by medicare. Which insurance company is her primary insurance?
Blue Cross Blue Shield is primary and Medicare is secondary they will the BCBS first and then bill Medicare.
Can you get tubal ligation with Medicare as primary and Blue Cross Medical as secondary?
I had a tubal ligation with Medicare as primary and Blue Cross Blue Shield secondary in 2008 thru Allina clinic in MN. I am very mad that it ended up costing me $1500 out of my pocket which to me makes no sense! Medicare paid $3000 and Blue Cross paid less than $100.
Does medicare part a pay the difference after Blue Cross which is primary carrier paid most of the claim for skilled nursing facility I have a 290 balance due the nursing facility?
Medicare does offer coverage for skilled nursing facilties. In order to find out if Medicare will pay as your secondary, the provider needs to submit it to Medicare. This statement is from the Meidcare.gov website: Medicare providers must submit claims (bills) to Medicare for you, whether Medicare is your primary or secondary insurer. For Medicare to process a claim as a secondary payer, the provider must give your primary insurance information to Medicare. You may also consider calling 1-800-Medicare for information about secondary coverage. If you do, remember from Nov 15th to Dec 31st is a busy time for Medicare so it may be difficult to reach them. One more hint to save some frustration: If BlueCross BlueShield has already paid the amount they were supposed to pay, calling them won't really help you because their job is done. Now the remaining bill is between the provider and Medicare.
What is tertiary insurance?
Tertiary insurance is the 3rd insurance policy responsible for payment. Example... Medicare, primary payor Blue Cross Blue Shield, secondary payor Aetna, tertiary payor
If you have medicare and they make a payment to a hospital that accepts medicare can blue cross as your secondary deny payment?
NO, not unless those services are a direct exclusion of your BCBS policy.
What primary school did Jessie from little mix go to?
Benhurst primary secondary school abbs cross
Does blue cross blue shield cover bariatric surgery under supplimentary Medicare coverage?
Any medical procedure connected to a Medicare plan will need to be proven medically necessary by the doctor. You doctor will know whether or not you can use your Medicare Supplement to pay for the surgery.
Which would be primary for my husband as I am working with Blue Cross Blue Shield coverage for both.?
You would each be primary on your own coverage and secondary on your spouse's.
If you have Medicare and Blue Cross which is primary provider?
In most cases, Medicare is primary. Some of the most common situations where Medicare can pay secondary are: -The individual or his/her spouse is currently employed/working and covered under an employer group health plan as a result of current employment. The company has 20 or more employees or participates in a multiple-employer or multi-employer group health plan where at least one employer has 20 or more employees. -Individual in question is entitled to Medicare as a result of a disability, the company has 100 or more employees, or participates in a multi-employer/multiple-employer group health plan where one employer has 100 or more employees. -The individual in question is Medicare entitled due to end-stage renal disease. Medicare is the secondary payer to a group health plan until a 30-month coordination period has ended.
My husband is retired due to disability he has healthnet I work and have anthem blue cross blue shield my husband is not getting his doctor bills paid- which is primary?
If you are actively working your policy is primary. If he has medicare then it is your policy, medicare and lastly Healthnet. If he is not eligible for medicare then it is your policy and then his. If you continue to have problems call BC/BS and ask them to do a conference call with Healthnet
