Wiki Medicare Secondary-collect a copy

[kanderson17]

If a patient has Medicare/Blue Cross secondary and the secondary covers at 75% - can we collect a copay at the time of visit towards the secondary coinsurance?

 

[philipwells]

You can but this doesn't make your patients very happy. If you have problem patients when it comes to paying their coinsurances, then absolutely, make them pay up front to see the physician. You have a business to run and copayments are so important to the success of a medical business.

I stress considering on not making this an every patient situation as some people will feel as though you don't trust them and they will take their business elsewhere.

 

[honeybee]

You have the right to collect the members cost share but it can be difficult to determine what they will owe after both plans processed. We stopped collecting all together when the patient has medicare with a 2ndary. Its too hard to know what COB rules could be followed and what the patients remaining balance will be even knowing their benefits. Will they follow the primaries allowable or their allowable, that can make a big difference in how 2ndary pays.

You could also collect just a flat amount, say $5 based on the coinsurance amount quoted by the 2ndary. We also ran into issues with multiple procedure rule adjustments, even when the 2ndary had a deductible and we knew they would not pay anything there was no way for us to factor that in so we'd almost always end up over collecting thus upsetting the patient even further.