Billing Secondary Insurances

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Billing secondary insurance for patients can be tricky at times. This video provides some common situations involving patients with secondary insurance and how to bill their claims correctly. Also, watchers will learn key terms used when dealing with secondary insurance such as coordination of benefits and the birthday rule.
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Hi! I’m Jennifer. After working in the medical field, in many different capacities over the last 15 years, I have learned much about where medical practice owners go wrong in running their businesses. I created this channel to try and assist medical practice owners from making the same mistakes as their colleagues. I want to see the private practice world of medicine grow and thrive. In my opinion, medicine has become too institutionalized, creating a lot of unnecessary obstacles and demands.
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Опубликовано:

15 ноя 2021

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Комментарии : 7

@itsirkeel 9 месяцев назад

Fabulous overview! I've learned a lot about secondary billing over the past year especially, but the inconsistencies are wild. Thankfully all of our secondary monies come via EFT and not checks. I have had to explain to patients why I can't bill a secondary when the clinician only has a contract with the primary and not the secondary. That doesn't mean they can't self-submit if they wanted, to, though, just in case they had OON benefits, right? But I'm not obligated to courtesy submit (everything is manual- we are private insurance only, so no Medicare/Medicaid and no COB) to a secondary when the clinician has no contract, correct? Thanks for being such a great resource!

@navigatingthebusinessofmed8251 9 месяцев назад

You are not obligated to bill any insurance. It is always a courtesy for submitting on behalf of patients. You just want your Financial Policy Agreement to reflect the company’s services in this regard and communicate what patients’ roles will be with all of these situations.

@montriceedwards9597 4 месяца назад

Your video was very helpful. Can you tell me if a patient has commercial insurance as primary and Medicaid as secondary. Do the patient still have to pay their co-pay if Medicaid doesn't cover it? Secondary (Medicaid) comes back as "CHARGE EXCEEDS FEE SCHEDULE/MAXIMUM ALLOWABLE OR CONTRACTED/LEGISLATED FEE ARRANGEMENT."

@navigatingthebusinessofmed8251 4 месяца назад

Hi there and thank you for watching! Unfortunately when you accept assignment with Medicaid you agree to not bill patients so you would not collect the copay in this situation. I hope this helps.

@josefernandez2722 5 месяцев назад

I have a weird situation. I have great insurance that covers me, my wife and my daughter. Only that it doesn't cover dental. So my wife can opt for insurance from her job, but it's all inclusive. She can't seperate the dental from the medical, and services are offered under one main location. My question is , if we still want to see are same doctors, that don't take my wifes new primary insurance, will the secondary still cover? We don't want to lose our doctors because of this.

@navigatingthebusinessofmed8251 5 месяцев назад

Thank you for watching! This is tricky. Medical insurance often does not cover dental and it does have to be purchase separately. I am honestly shocked your wife needs to have it included as it is paid for separately. Did she check with her HR department to see if she can just pay for dental and not medical? That is often okay. If not, it depends if her primary insurance has out of network benefits and it’s not an HMO type situation. If you could keep covering the medical on your work’s insurance and she could just get dental for everyone, that would be ideal. If not, then the secondary coverage situation is tricky and may not be worth it. Please email me at jennifer@icsolns.net if you need other assistance. I’m not 100% sure I can help, but I’m happy to try if you can provide more specifics in the email. Thanks!

@josefernandez2722 5 месяцев назад

@@navigatingthebusinessofmed8251 Thank you for taking the time to reply. I will surely do some more digging.