Wiki Secondary payment

[Bhoward19]

What is pt responsibility: example: Procedure cost is $500 / primary pays $250 and insurance write off is $100 = pt balance $150. Secondary pays patient (out of network) $250. What is the total patient should pay the office (taking into consideration the secondary ins payment went to patient)?

 

[sls314]

What is pt responsibility: example: Procedure cost is $500 / primary pays $250 and insurance write off is $100 = pt balance $150. Secondary pays patient (out of network) $250. What is the total patient should pay the office (taking into consideration the secondary ins payment went to patient)?

The patient should pay the $250. Sometimes a secondary payer does pay more than the primary allowed amount - it's not super common, but it does happen. (There are some secondary payers that don't limit their payment to the primary allowed amount.)

The money paid by the secondary is intended to pay the provider for the service rendered. Not go into the patient's pocket.

 

[LisaAlonso23]

This happens a lot. The patient should pay the $250 that was sent to him/her that was designated for the provider. If they don't pay after receiving three statements, send them to collections for taking what's not theirs.