Secondary billing to ASH

I am wondering if I can balance bill when the primary has applied their payments and the patient has a co-insurance owing. Secondary ASH pays only $64 per visit and therefore since the primary allowed and paid are more than the $64 can I balance bill the patient their co insurance from their primary?

Hello,

If you are In Network with both Primary and Secondary Insurance and have accepted the Assignment of Benefits(AOB), then you must allow the Secondary insurance to make the ultimate decision of what the patient's responsibility is. You may not balance bill based on the Primary Insurance because they allow more.

Think of it this way: if Medicaid were secondary, would you balance bill the patient? The answer is no. You must accept the EOB response of the secondary and not balance bill on the Primary Insurance information.

Feel free to email me at PacificCoastlineMedBilling@gmail.com if you have any other questions.


Cindy