Wiki Denial

[valeriemm]

We have a non covered service of refraction . We know its a non covered service by Medicare. Are we required to file for patient ? Patient states her secondary will pick up the Medicare denial? I know all secondary's follow Medicare. guidelines. Anyone have experience with this?

 

[TiffanyM101]

You should bill it to the second insurance for the pt even though Medicare didn't allow it that shows the pt you did submit it. We always file our refractions to secondary even if we know we will get denied. (some secondary insurances do pick up the cost of the refraction) I hope this helps

 

[eyebillinginbox]

You should bill it to the second insurance for the pt even though Medicare didn't allow it that shows the pt you did submit it. We always file our refractions to secondary even if we know we will get denied. (some secondary insurances do pick up the cost of the refraction) I hope this helps

I agree.
(Also billing refractions Medicare primary/ Tricare secondary, bill to Medicare w/ -GY modifier)

 

[sls314]

We have a non covered service of refraction . We know its a non covered service by Medicare. Are we required to file for patient ? Patient states her secondary will pick up the Medicare denial? I know all secondary's follow Medicare. guidelines. Anyone have experience with this?

That's not correct that "all secondaries follow Medicare."

Secondary insurance just means that it comes after Medicare. That secondary policy could have its own rules and benefits, including things that aren't covered by Medicare primary.

(Perhaps you're confusing Medigap/Medicare supplement policies with all types of secondary policies?)

 

[CBLENNIE]

Even some Medigap/Medicare Supplement policies have a routine vision benefit. The insurance company does include routine vision benefits on most of our Medicare Supplement policies. I would suggest you consider submitting all of your secondary claims and as you may get payment you weren't expecting, and it will be helpful for the patient to not be out the cost of the refraction.

 

[valeriemm]

Thank you all !