Wiki COB issues

[m*larusch]

I wanted to get some feedback on COB issues we have been seeing in our office. We have recently had quite a few patients come in with 4 insurances. In our system we show the patient has sometimes 2 and sometimes 3 insurances but we end up getting payment from 4 different companies. When we call each company to verify coverage they all state they are "secondary" and they will not be requesting their money back. We notify the patient's but sometimes the patient's are confused about what order the insurances should go in. We are wondering in these situations who is owed the money back?

The majority of the time Medicare is primary and then the patient has insurance through their retirement, and they usually are paying for a secondary as well. And then sometimes there is even coverage through a spouse. We are seeing this more and more and we just wanted to see if anyone else is having this issue and how you are handling it.

Any feedback would be appreciated.

 

[slivingston]

I used to work for an insurance company doing COB. Unfortunately it is up the patient's to call each and every insurance to notify them of the other insruances and how they have each insurance.
The rules to who is primary and secondary can be very confusing. To address your quick example above
Medicare primary through retirement; Medicare Primary, Private insurance through former employer second, Spouses Plan (as long as spouse is also retired) third and last would be a plan that the patient has out right paid for out of pocket through no employer. There are many many different ways this could go based on the individual circumstances. Feel free to private message me with any specific examples and I will help out all I can. I did this for many years and I know how confusing it can be. Good Luck!

 

[m*larusch]

Thank you so much Stephanie I really appreciate it. I figured it was up to the patient but they are so confused themselves! I will definitely let you know if there is a specific issue!