Wiki Past timely filing - secondary ins

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june616

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Hello! I'm working VERY old AR and found a claim from August 2012 that Medicare applied to the patient's deductible. Patient has BCBS as their secondary insurance and they do not have this claim on file. I'm not 100% sure what to do at this point. I could file to BCBS (and it would most likely deny) but I do not even have the Medicare EOB. Would I bill the patient for their deductible or write it off? Thank you. :confused:
 
There is a chance that Medicare filed a claim on behalf of the provider automatically. In many cases, the secondary provider information is on file, or if it was included on the claims as the secondary, with pertinent information it may already be in BCBS system. I would look for the Medicare EOB, or ask for another one. If it was filed with the secondary, there is a possibility the money may have been sent to the beneficiary already. Either way, its worth a try. Id also bill the patient to generate contact, and maybe you can enlist his/her assistance in resolution.
 
I would get a copy of the Medicare remit first, see if it did cross-over to their BCBS plan first before I would ever send a statement to the patient. If the patient does owe it, you will want to have copies of both remits showing that indeed it was applied to deductible. Because in a worse case scenario, and you would have to send this patient to collections; you better have your proof that they truly do owe that amount. Nothing like having egg on your face if your ducks aren't lined up. But, that is just me.....my M.O., good luck.
 
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