Wiki Insurance Question

[colleensso]

Hey Everyone,
I am having a little problem. I had a patient who had septo surgery, billed out all the proper codes. The patient has United Healthcare primary and bcbs secondary. I am having a little argument with bcbs and I may be wrong, but when a patient has a secondary plan does the secondary insurance plan pick up the co insurance go according to their fee schedule or the fee schedule of the primary ins? She is not even sure now?

 

[jthweatt]

Usually an insurance carrier pays according to their own fee schedule. So if you are contracted with BC and the primary insurance paid more than BC allowable you might get a remittance indicating that you must contractually adjust the balance. No payment from BC and no billing the patient.

Jerri, CPC