Wiki Billing secondary insurance

[ANGELNURSE]

Our office is NOT contracted with a primary insurance United Healthcare, but we are contracted with the secondary Molina. Since we are not contracted with the primary, can we bill the secondary only? Or do we have to bill UHC, get denied, then bill the secondary insurance Molina? Any help would be helpful.

Thank you.

 

[CodingKing]

Primary denial would be needed.

 

[thomas7331]

You'll need to bill the primary insurance first. Payer systems are set up to coordinate benefits for patients with other insurance - if you submit to the secondary but the primary carrier's payment or denial information is missing, the secondary insurance will also deny the claim.

 

[daedolos]

The secondary will need the EOB before making any payments. A lot of the time, the secondary will not pay because the primary has "paid max benefits allowed" especially when dealing with Medicare as the primary. Nevertheless, you need resolution with the primary before dealing with the secondary.

Peace
@_*
Good luck