Reader Question:
Check Specifics Before Reimbursing Tertiary Insurer
Published on Mon Jul 16, 2012
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Question:
One of our patients has Medicare as her primary insurance and Gerber Life as secondary. We received a payment from another payer who must be tertiary. Do we owe the refund to the patient or the tertiary payer?
Rhode Island Subscriber
Answer:
The correct way to handle the situation depends on the circumstances.
- If there is no balance due and the patient did not pay anything to your group, then you reimburse the tertiary insurance.
- If the patient paid you anything for the service, you reimburse her what she paid and anything left over (if any) goes to the tertiary insurance.