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Can a dental office bill a secondary insurance company after the primary HMO lists the service as no charge?
Wiki User
∙ 15y ago
Why not? What are the terms of the 2nd Insurance?
Wiki User
∙ 15y ago
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Do you need to obtain prior authorization from your secondary insurance even if the primary insurance will be billed first?
Your secondary insurance has different PA criteria than your primary insurance. A PA means that your insurer will only cover a service under certain circumstances; company A may cover a service for 3 conditions and company B may only cover the same service for only 2 conditions. Your primary could pay and your secondary may not.
What is meant by primary and secondary insurance coverage?
Primary insurance coverage is what is first used when a medical service is being rendered. This is what will be billed first. Secondary insurance is supposed to cover what the primary insurance does not.
If the primary insurance allows more than the secondary insurance what would the secondary insurance pay?
Secondary insurance will not pay the claim but the remaining charges should not be billed to the member/patient. Provider of service should write off the patient responsibility that primary insurance applied.
If a child has primary and secondary medical insurance who settles the dispute when the primary decides the secondary should now be primary instead of secondary as they had been for several years now?
It's not at the discretion of the insurance company as to who is the primary or the secondary. It is the sole decision of the policy holder(you). They are a paid service and are there to serve you. Correction: No, it's not at the discretion of the policy holder. The primary coverage is based on who's birthday comes first. For example, in this particular case, the child lives with his mother and stepfather, and the stepfather and the biological father both have him on their medical insurance policies. The father's birthday is in October and the stepfather's birthday is in December. So the father's insurance is primary, and the stepfather's insurance is secondary. These are the quidelines insurance companies use to determine which one is primary, and which one is secondary.
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. This process is called coordination of benefits. 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 secondary is established by a shared rule between insurance companies. It is not the policy holder's choice. Examples of Primary/Secondary coverage: A husband and wife both work and carry the medical insurance offered by their respective employers. The husband adds his wife to his policy. The wife adds her husband to her policy. Under most circumstances, the husband's plan would be his primary policy and his wife's plan would be his secondary policy. In like manner, the wife's plan would be her primary policy and her husband's plan would be her secondary policy. Secondary insurance should not be confused with supplemental insurance. Supplemental policies usually abide by the primary insurance guidelines. If the primary allows the charge, the supplemental will allow the charge. Most supplemental policies cover the charges you would normally pay out of pocket. For example: A Medicare supplemental policy would cover the 20% coinsurance left over after Medicare pays 80% of the allowed amount.
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 amount that each insurance has agreed to pay. If the primary pays more than the secondary would have paid -there may be a refund due. However, there may be co-pays and deductibles to be met with both insurance policies. There could also be write downs--- you should only pay the lesser amount the provider may have to take a loss if one insurance has a lower contracted amount
Will secondary health insurance cover what primary does not?
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 rates 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.
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 secondary is established by a shared rule between insurance companies. It is not the policy holder's choice.Examples of Primary/Secondary coverage: A husband and wife both work and carry the medical insurance offered by their respective employers. The husband adds his wife to his policy. The wife adds her husband to her policy. Under most circumstances, the husband's plan would be his primary policy and his wife's plan would be his secondary policy. In like manner, the wife's plan would be her primary policy and her husband's plan would be her secondary policy.
What is secondary insurance?
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 secondary is established by a shared rule between insurance companies. It is not the policy holder's choice.Examples of Primary/Secondary coverage: A husband and wife both work and carry the medical insurance offered by their respective employers. The husband adds his wife to his policy. The wife adds her husband to her policy. Under most circumstances, the husband's plan would be his primary policy and his wife's plan would be his secondary policy. In like manner, the wife's plan would be her primary policy and her husband's plan would be her secondary policy.Secondary insurance should not be confused with supplemental insurance. Supplemental policies usually abide by the primary insurance guidelines. If the primary allows the charge, the supplemental will allow the charge. Most supplemental policies cover the charges you would normally pay out of pocket. For example: A Medicare supplemental policy would cover the 20% coinsurance left over after Medicare pays 80% of the allowed amount.
What is primary secondary and tertiary economic activities?
Primary - gathering of raw materialssecondary - manufacturingtertiary - service jobs
Where can one get information on services from Charles Schwab Insurance?
You can get information on service from Charles Schwab Insurance in the official website of the insurance company. In addition, you can call customer service of the company.
What if my Health Insurance Does Not Cover A Planned Service?
In such a case talk to your insurance company regarding this and get clear what service are covered and what service does not cover. Also refer the insurance plan you buy from insurance company. May be there should be a way to file a grievance.
