Reader Question:
Dig into Specifics Before Reimbursing Tertiary Insurer
Published on Mon Jul 02, 2012
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.