# secondary insurance



## brandie_orozco@cibolahospital.com (Nov 30, 2010)

This may sound like a dumb question but I need to get some help, If a patient has two insurance and the primary insurance pays and I bill the secondary insurance and they leave the balance to the patient deductible, do I bill the patient with the remaining bill or write it off. brandie


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## sabar (Nov 30, 2010)

Yes, you bill the patient. It is up to the physician if he/she wants to write off the outstanding balance.

Faiza


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## capricew (Nov 30, 2010)

brandie_orozco@cibolahospital.com said:


> this may sound like a dumb question but i need to get some help, if a patient has two insurance and the primary insurance pays and i bill the secondary insurance and they leave the balance to the patient deductible, do i bill the patient with the remaining bill or write it off. Brandie



of course you bill the patient!  Be careful when writing off patient portion of bills.  Many insurances, particularly medicare and medicare based insurances, consider it fraud if you bill medicare but write of the patient portion.  Medicare states, as a provider you can choose not to bill the patient and write off their patient responsibility, but if you chose to do that then you cannot bill medicare.  If you do bill medicare then the patient must be held responsible for their portion otherwise it is fraud.

At my facility, we use this guide for all insurances, not just medicare.


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## Jamesmmm (Dec 1, 2010)

I agree...before writing off balances, it is necessary to show that you attempted to collect, and many times, your internal auditors will want to see your collection efforts AND a note from the patient pleading financial hardship. Medicare regulations specify same...


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