Wiki Billing Secondary commercial payers

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droque

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Hi everyone :) Wondering if anyone could help answer my question in Billing the secondary commercial plan. Just an FYI- Primary is also commercial. Which amounts do we bill the secondary plan? The all amounts that the primary did not cover including denied procedures? Only patient responsibility? Or bill the full original amount from the primary claim and attach EOB? I have not been successful finding answers. Thank you!
 
The secondary will only pick up what is the patient resp. If your primary denied, you would need to work that denial. The secondary will not pick up any denials. If the denied reason code is a PR- not a CO then this is considered pt resp and the primary EOB can be attached and sent to the secondary.
 
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