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Practice Management Alert

Reader Question:

Check With Secondary Insurance on Coverage of Copays

Published on Thu Oct 14, 2004

Question: A patient's primary insurance had a $15 copay, which we collected from the patient at checkout. The primary insurance paid for the patient's office visit and, since we already collected the copay, the claim is paid in full. If we had not collected the copay at the time of service, could we bill the secondary insurance for this amount?

- New Hampshire Subscriber Answer: Whether you can bill the secondary insurance for a copay will depend on the specific coverage the secondary carrier offers.

Billing can get very confusing when a patient has primary and secondary insurance. You should always abide by what the primary insurance dictates first. A secondary insurance is there to cover whatever the primary doesn't cover - but this coverage may or may not include copays. A quick phone call to the secondary insurer should give you an answer. If the secondary will not cover a copay, you would need to collect from the patient.
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