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2ndary Insurance copay

cfwh671

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A patient has primary insurance copay $10 for Dr's office visit
Their secondary insurance copay is $25 for Dr's office visit
How much does the office charge the patient at the time of her appointment?

My understanding is after the primary insurance's remittance advice is submitted to the secondary insurance with the claim form, the secondary will pay 100% after their $25 copay is met. Based on this rule (that I might be wrong about) the patient should pay a $10 copay at the appointment.

Thanks in advance for any advice.
 

CodingKing

True Blue
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Typically the secondary will only pay the $10 copay and nothing more leaving a $0 balance. Worst case bill the $10 and refund if the secondary pays.
 
Last edited:

honeybee

Networker
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Billing Solutions Lead

We always collect the lesser of the 2. Generally speaking the patient should not usually owe more than the lowest between the 2.
 
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