Wiki Law on cob adjustments

laurabryant

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I hope someone can help me i have a few questions on taking write offs when dealing with dual coverage. I thought you only take the write off from the primary insurance, but isn't there an exception when you can take the secondary instead of the primary's? If you are not providers with the primary insurance but you are with the secondary then do you have to take the write off on the secondary insurance since your not taking one with the primary because your not a provider? One last question ..... If the primary insurance denies for preexisting condition there isn't a write off, but if the secondary pays do you have to take a write off since you didn't on the primary? I hope i am making since and someone can help me!
 
For COB, if you are contracted with either insurance you are obligated to write off something. How much of a write off depends on the situation.

If you are contracted either plan, you must take contractual write offs, but you can limit it to which one is the highest. Take the write off on the primary and when the secondary comes in, compare it to the primary plan. If the secondary has a greater write off, then add the difference to what you took on the primary plan. If the secondary write off is less than the primary, then you do not have to change what has already been written off. Between two insurances with payments and write offs, you should not end up with a credit on the account.

If you are not contracted with one plan or the other, you are not obligated to take write offs on the non-contracted plan, but you must always consider contractual write offs for plans you are contracted with, no matter if they are the primary or secondary plan. You must consider each plan individually in these cases.

I hope this helps...
 
Thank you so much that helps alot, but i am kind of confused on one thing....if you are contracted with the primary and secondary insurance you always take the greater write off...right?
 
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