Ineligible Primary Payer

kendalb

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If the patient is ineligible for the primary insurance but has Medicaid listed as secondary and Medicaid has on their file the patient's primary insurance is active (eligible) how should this be billed?
 

Walker22

True Blue
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Cumming, GA
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If the patient is ineligible for the primary insurance but has Medicaid listed as secondary and Medicaid has on their file the patient's primary insurance is active (eligible) how should this be billed?

You must file to primary, get a denial, then bill Medicaid as secondary.
 

kendalb

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The primary payer is Aetna and the reject the claim if the patient is not eligible before the even process it to receive a denial.
 

twynett80

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Kasenya Jenkins, CMA,CPC-A,CPB

If Aetna is denying the claim stating the patient is ineligible then Medicaid would become primary. The patient also may need to update COB with Medicaid. I would contact the patient to verify coverage.
 
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