kcowan
Guest
WE HAVE A PATIENT THAT HAS BCBS THRU FATHER (OUT OF STATE BCBS), MOTHER HAS BCBS OF TEXAS SECONDARY. THE PRIMARY HAS PAID ON CLAIMS, THEN WE FILE TO THE SECONDARY (HEB) BUT THE 2ND IS MAKING NO PAYMENT?
PRIMARY BENEFITS DED (FAMILY) 4500 DED MET 90/10
SECONDARY BENEFITS OV COPAY $55, $350 DED MET 80/20
THE ALLOWED AMOUNTS FOR PROCEDURES ARE THE SAME FOR BOTH INSURANCES, THE PRIMARY PAID 90% ON THE CHARGES THE E/M 99214 HAD A BALANCE OF $10.13. THE PROCEDURE HAD A BALANCE OF $25.98, I THOUGHT THAT THE SECONDARY WOULD COME AN PAY 80% OF THE BALANCE LEFT ON THE PROCEDURE, BUT BCBS 2ND IS TELLING NOPE NOT.
PRIMARY BENEFITS DED (FAMILY) 4500 DED MET 90/10
SECONDARY BENEFITS OV COPAY $55, $350 DED MET 80/20
THE ALLOWED AMOUNTS FOR PROCEDURES ARE THE SAME FOR BOTH INSURANCES, THE PRIMARY PAID 90% ON THE CHARGES THE E/M 99214 HAD A BALANCE OF $10.13. THE PROCEDURE HAD A BALANCE OF $25.98, I THOUGHT THAT THE SECONDARY WOULD COME AN PAY 80% OF THE BALANCE LEFT ON THE PROCEDURE, BUT BCBS 2ND IS TELLING NOPE NOT.