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If secondary agreed upon insurance is lower than the primary insurance agreed upon price which one can the provider bill the paitent?

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2008-08-24 06:03:10
2008-08-24 06:03:10

Primary has to process and pay claims first then secondary will process and pay leftover expenses according to their policy provisions. The secondary sometimes excludes payment towards a primary policy deductible.

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Related Questions


You should or you customer WILL be PISSED for having to do the leg work of getting the information of what the primary paid and getting it to their secondary.


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.


No, it's fraudulant. It's not practical, the secondary insurance should pay the remainder of the cost the primary insurance doesn't cover.


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.


Yes, and you want them to because if they are paid out of order then it will be a mess to correct.


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


The secondary insurance cover both pays and co-pays of the primary insurance depending with the insurance company.


Yes, if the secondary insurance plan covers it In the pharmacy (drugs) world of primary and secondary coverage, this is true.


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.


Yes, you can. The other insurance would be primary though and the Medicaid secondary.



You cannot decide which insurance is primary and which is secondary. Their is nothing you can do to determine this. Within each policy it specifies when each policy is primary or secondary. With Medicare, it is always going to be secondary to insurance provided by an employer or retirement plan.


Yes, If medicare pays more than the secondary insurance allows for a charge, the secondary insurance pays nothing. The balance is written off to a contractual allowance that is agreed upon between the provider of service and the insurance company via contract.


they can't actually "require" it but any insurance can contract with Medicare to be secondary, provided both parties agree


If you have insurance through your employer, and you are the policy holder,(the insurance is in your name) this insurance will be primary for you, and your spouses insurance policy will be secondary. The insurance policy thru your spouse's employer, (your spouse is the policy holder, or the insurance is in their name), this would be primary for your spouse, and your policy would be their secondary. Here's the phamplet from Medicare http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf


pertaining to medical insurance; primary secondary TERTIARY IS THE ANSWER


if primary paid more than allowed amount or if patient has primary insurance


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.


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 would always send me a check for the copay a month later because the secondary paid it.


== == If secondary insurance denies coverage, YOU get to pay the bill. == ==


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.



There is one major difference between these types of claims. When a person has two different insurance carriers, one of them is designated as the primary coverage and the other as the secondary. The primary insurance should be billed first and normally pays the bulk of the bill. The secondary insurance gets billed for the remainder of the bill which the primary insurance did not pay for.


Medicare becomes the primary insurance if you drop your employer insurance. Up until you drop your employer insurance, Medicare would be your secondary insurance.




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