jebond123
Networker
- Messages
- 36
- Location
- Vancouver, WA
Hello,
One of our patients neglected to inform us that she had HMO as her primary(we are not in-network with this one). She presented her 2nd insurance (thru her spouse) only. That insurance does not show other insurance present and paid all of our claims as primary payer. Now that I am aware of the other insurance, my instincts tell me to submit claims to the HMO for a denial and then resubmit the orig claim once again to the second insurance as a corrected claim with eob from primary. I also strongly advised the patient to notify her 2nd insurance of the existence of the first. Does this sound like the right path to follow? I am always unsure of how to correct this specific scenario.
Any guidance is appreciated.
Thanks,
Janet
One of our patients neglected to inform us that she had HMO as her primary(we are not in-network with this one). She presented her 2nd insurance (thru her spouse) only. That insurance does not show other insurance present and paid all of our claims as primary payer. Now that I am aware of the other insurance, my instincts tell me to submit claims to the HMO for a denial and then resubmit the orig claim once again to the second insurance as a corrected claim with eob from primary. I also strongly advised the patient to notify her 2nd insurance of the existence of the first. Does this sound like the right path to follow? I am always unsure of how to correct this specific scenario.
Any guidance is appreciated.
Thanks,
Janet