Wiki Secondary Payer and NPP

[gndhoward]

Curious as to how others handle this situation:

Primary Insurance, Medicare, claim is submitted under NPP. Secondary payer does not credential NPPs and Payer denies claim. How do you file the claim to get it paid?

Thanks in advance for any help.

 

[mitchellde]

Curious as to how others handle this situation:

Primary Insurance, Medicare, claim is submitted under NPP. Secondary payer does not credential NPPs and Payer denies claim. How do you file the claim to get it paid?

Thanks in advance for any help.

If the service does not meet the requirements for inciden-to then you will not be able to get the payment from the secondary. Possibly you could try it as out of network but that may not be successful either.