Question: Virginia Subscriber Answer: In most cases, after you've received both payments, you'll take the adjustments from whichever insurance has the larger adjustment. You should not take adjustments from both plans, nor should you write off deductibles. You'll bill the patient for any remaining balance that is his responsibility once you have both payments. Of course, individual payer contracts reign when determining where to collect. Hint: Some secondary insurers pay the primary's co-pay (including Medicaid as the secondary insurer), but many do not. Most experts recommend collecting the co-pay from the patient at the time of service, especially if you're unclear on whether it will be covered by a secondary payer. If it's later paid by a secondary insurer, it can be credited to the patient's account or refunded back to the patient."