Wiki "Balance Billing" Secondary, ok?

[akalyssarae]

If you are in network with the primary, who generally has significantly less allowables are you required to apply those adjustments before sending to secondary? Office is in network with both insurances however unsure on what we are allowed to bill to the secondary, just what prim puts as PR or entire remaining balance of charges?

 

[ItsJustFaith]

Yes; after the primary carrier has paid, you should only submit the balance left from the allowable amount to the secondary carrier. (They may indicate that it's part of the patients coin/deductible)

If you are in network with the primary, who generally has significantly less allowables are you required to apply those adjustments before sending to secondary? Office is in network with both insurances however unsure on what we are allowed to bill to the secondary, just what prim puts as PR or entire remaining balance of charges?