What would you like to do?
Will secondary insurance cover claims denied by your primary insurance?
As long as it is a covered expense by your secondary insurance and a claim has been filed with the primarty insurance then the answer is yes. The secondary insurance will only cover the expense according to your plan.
39 people found this useful
Was this answer useful?
Thanks for the feedback!
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 Medicare denies a service all together, the supplemental plan is often under no obligation to pay at all, as they are there to "supplement" Medicare, not take the place of it in cases of denial. This is especailly true if Medicare denies because the service was deemed "not medically necessary". So, in short, no. Medicare supplements often do not cover services if they are denied by the primary (Medicare).
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 received the claim within timely filing, you may have the option of submitting the claim to your secondary with proof that it was filed in a timely manner. If that doesn't work you can always appeal the decision with the secondary or for that matter the primary insurance company. Policy holders are not responsible for claims that deny for timely filing.
Is it possible for an insurance company to deny your claim because you have a primary and they can not be a secondary?
Answer Conference the 2 claims reps together and let them Duke it out!
Depending on your coverage, your primary insurance will cover 80% of your charges, minus your deductible (if not already met). Your secondary insurance will pick up the remain…ing 20% co-insurance and your co-pay, if you have one.
The secondary insurance cover both pays and co-pays of the primaryinsurance depending with the insurance company.
If secondary insurance denies coverage, YOU get to pay the bill.
Medical Insurance Answer What does the brochure or policy Evidence of Coverage for the secondary policy say?
Can the secondary insurance provider deny a claim that was not filed with the primary insurance provider first?
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.
Not necessarily; a secondary insurance policy or plan might only provide additional benefits up to the maximum that it will pay for a specified service. If both plans have rat…es that are similar, this might result in a small additional payment. Some secondary insurance or health plans might pay up to their maximum -- in addition to what the primary pays, which would result in a higher payment against a claim.
IF Patient primary insurance denied claim because provider is not contracted with them will secondary insurance pay on the claim?
You have had payments for claims recouped because the insurance company was secondary the primary insurance company is denying the claims recouped due to timely filing Is there anything you can do?
If your health insurance is thru your employer, have them contact their account rep. These issuse can be magicaly resolved when it is time to renew the company policy, if the …rep is informed thast the company will seek another provider should it not be taken care of.
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 bene…fits. The spouse's insurance is secondary, and will only pay once the primary insurance has paid. Depending on how the policy is written, sometimes the secondary insurance will pay any residual fees up to the annual maximum. Sometimes the secondary insurance only pays if their fee schedule allows higher fees than the primary insurance. This assumes that each spouse is named as a dependent on each other's policy. Ask the insurance coordinator at your dental office to what benefits are available between the two policies.
If your primary insurance denies a claim for failure to have a referal will your secondary insurance pay the claim?
Read your policy
yes, they will treat it as if the primary was a different company. You pay two premiums. If they do not, contact the DOI.
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 th…e secondary policy longer/ or the pre-x period has already been satisfied, then they may pay the claim as secondary. As long as the treatment is indicated as covered benefits in the policy. These cases are common when both spouses have covered each other on their jobs. And/or when a child is covered under both parents policies. There could be a coordination of coverage issue with the latter.
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.
Today accident management companies facilitate quick recovery of claims, they need not wait till the whole case is resolved. So you must visit an accident management inter…mediary service provider for your damage assessment. Visit source for more info: