JonesJeeps
Guest
When a Patient has 2 commercial insurances do you apply the adjustments from both insurances to the claim?
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Patients with 2 commercial insurances
- Thread starter JonesJeeps
- Start date
cgaston
True Blue
They are both going to have their own allowed amount, so I accept whichever is higher. You are allowed to collect your entire contracted amount from an insurance company.
Say you participate with both carriers and you have a $300 charge. Insurance 1 allows $150 and they pay $150 but Insurance carrier 2 allows $200. I would not write off anything after Insurance 1's payment and bill Insurance carrier 2 fo the balance. Insurance 2 should pay the balance up to their allowed amount of $200 (an additional $50). I will then accept their contract amount as payment in full and adjust off the remaining $100.
Say you participate with both carriers and you have a $300 charge. Insurance 1 allows $150 and they pay $150 but Insurance carrier 2 allows $200. I would not write off anything after Insurance 1's payment and bill Insurance carrier 2 fo the balance. Insurance 2 should pay the balance up to their allowed amount of $200 (an additional $50). I will then accept their contract amount as payment in full and adjust off the remaining $100.