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If the primary charges a 200 copay the secondary pays nothing do you owe the 200 copay on the primary if secondary states 0 owed by patient Where can you find this info?

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2005-10-12 14:39:55
2005-10-12 14:39:55

This does not sound like an auto policy, is this medical? If so, you are responsible for the copay. I would contact your benefits administrator.

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non covered charges according to the medicare remittance. Medicaid will pick up the 20% of medicare covered charges.

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.

WHEN MEDICARE IS PRIMARY, THE PATIENT IS RESPONSIBLE FOR THE SECONDARY COPAY.

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The answer to the question, is it depends. State laws on coordination of benefits (CoB) can impact the answer, but there is a general rule of thumb. If the dentist participates in a network that is connected to the patient's coverage--whether that coverage is primary or secondary, the participating network contractual relationship determines the amount that can be collected from the patient.Here's a table that was developed by the National Association of Dental Plans outlining various CoB scenarios and what determines the charges to patients under each.PATIENT COVERAGEWHAT THE DENTIST CHARGES THE PATIENTPrimary and secondary coverage are both DPPOs; Office participates in both network plans.The DPPO allowances of the primary plan.Primary coverage is a DPPO, and the secondary coverage is an indemnity plan.The DPPO allowances of the primary plan.Indemnity plan is primary, and the secondary coverage is a DPPO.The DPPO allowances of the secondary plan. Primary coverage is an DHMO, and the secondary is an indemnity plan.The DHMO patient co-payments. (The secondary indemnity plan may cover all or most of these co-payments.)Indemnity plan is primary, and the secondary coverage is an DHMO.The DHMO patient co-payments. (The primary indemnity plan may cover all or most of these co-payments.)Primary coverage is a DPPO, and an DHMO is the secondary plan.The DPPO allowances of the primary plan.Primary coverage is an DHMO, and the DPPO is the secondary plan.The DHMO patient co-payments. (The secondary DPPO plan may cover all or most of these co-payments.)NOTE: Discount dental plans are not subject to COB laws and regulations as they are not insurance products.

When a DPPO is primary coverage, the charges paid by the patient are based on the agreed DPPO discounted fees--not the DHMO schedule of charges. The dentist would bill the DPPO for the procedures performed. If the dentist is in the DHMO network, he or she would also get his or her regular capitation payment for that patient.

That is if the secondary does not have a clause in it that "they will not duplicate benefits" If so they will not always pay the difference. They will figure out the amount they would normally pay, subtract what the primary pays from that amount and pay the difference (which with mine is little to nothing and I end up paying the balance of the bill) Nothing really happens, one is the primary and the other is the secondary insurance for the patient. Primary insurance will pay up to 80% of allowed charges if the deductible is met, and the secondary insurance will pay the remaining 20% of the claim, again, if the deductible for the year has been met.

A transformer' primary winding is connected to the supply, whereas its secondary winding is connected to the load. The term's 'primary' and 'secondary' have got nothing to do with voltage levels.

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

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Is the patient responsible for deductible and coinsurance if primary insurance paid more than secondary would have allowed.

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