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Wiki Biller
- Thread starter hholland
- Start date
It also costs your company money for each claims submission. I don't know what the current cost estimation is per claim, but at one time, I heard $3-5 per claim. (That was years ago, though, prior to electronic claims submission!
) Though I am sure it costs less now, it does still cost. (cost of employee and the vendor has to take their chunk)
) Though I am sure it costs less now, it does still cost. (cost of employee and the vendor has to take their chunk)Herbie Lorona
Expert
I would say yes you would still want to submit the claim to the secondary. The secondary insurance may have a higher allowable then the primary so they would pay that difference.
Here is what I found from WPS Medicare.
Should I Bill Medicare When the Primary Insurer Paid in Full?
My patient provided primary insurance information and the insurance company paid in full. Do I still need to submit a claim to Medicare?
Medicare recommends you submit the claim for secondary benefits even though there is no outstanding balance. The reasons for this include application of the patient's deductible for allowed services, notification of certain once in a lifetime benefits, recording of certain time restricted services, and allowing Medicare to keep the claim on file. This last one becomes vitally important when the primary insurance company requests the payment back.
The Centers for Medicare & Medicaid Services (CMS) Internet Only Manual (IOM) Publication 100-05, Chapter 3, Section 10.5Adobe Portable Document Format indicates that a primary insurance take back alone does not constitute good cause to waive the 1 year filing limit. However, if we already have the claim on file, we may be able to perform a reopening. You can find more information on good cause for waiving the file limit and reopening on our website. Please see our Claims and Appeals pages.
http://wpsmedicare.com/j5macpartb/claims/submission/primary-paid-full.shtml
Here is what I found from WPS Medicare.
Should I Bill Medicare When the Primary Insurer Paid in Full?
My patient provided primary insurance information and the insurance company paid in full. Do I still need to submit a claim to Medicare?
Medicare recommends you submit the claim for secondary benefits even though there is no outstanding balance. The reasons for this include application of the patient's deductible for allowed services, notification of certain once in a lifetime benefits, recording of certain time restricted services, and allowing Medicare to keep the claim on file. This last one becomes vitally important when the primary insurance company requests the payment back.
The Centers for Medicare & Medicaid Services (CMS) Internet Only Manual (IOM) Publication 100-05, Chapter 3, Section 10.5Adobe Portable Document Format indicates that a primary insurance take back alone does not constitute good cause to waive the 1 year filing limit. However, if we already have the claim on file, we may be able to perform a reopening. You can find more information on good cause for waiving the file limit and reopening on our website. Please see our Claims and Appeals pages.
http://wpsmedicare.com/j5macpartb/claims/submission/primary-paid-full.shtml