Medicare primary, commercial secondary

laharp4

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This is not something I have come across before...Medicare is the primary and responds with a co-ins amount. The secondary says that the allowable charge is less than Medicare's and that the difference between the two is not patient responsibility. I did not think that anyone could undercut Medicare like that. Anyone see this before?:confused:
 

deborahtuck2010

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I have unfortunately seen this on numerous occasions. You will have to write off the patient balance unless you are not a par provider for the secondary commercial carrier.
 

KELLEYJKING

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Mcare prime, comm 2ndary

The rule is if Mcare pays as much or more that the commercial carrier allows you write off the balance. This almost always happens with Mcaid but it can occur with commercial insurances as well. Hope this helps!
 

pamsbill

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The rule is if Mcare pays as much or more that the commercial carrier allows you write off the balance. This almost always happens with Mcaid but it can occur with commercial insurances as well. Hope this helps!
Only if you participate with the secondary insurance though. If you do not, you can bill the patient.

PJM
 
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