Wiki Patient responsibility

[mcgeachyc@bellsouth.net]

Hello,

Filed a claim of $200.00 to Primary, commercial policy, which allowed $175.20 and applied to patient's deduct. Secondary, also commercial policy, received primary EOB, but their allowable is $150.00 also applied to deductible. Should we bill patient the deductible from the primary or 2ndary claim?

 

[cgaston]

It depends. If you have a contract with the secondary carrier you have agreed to accept their allowed amount as payment in full. Since you have already received that amount you would have to write off the $24.80. If you do not participate then you can bill the patient the balance due.