Wiki Primary Insurance

[rosa123]

Hello! if someone can help me, we have a pt with commercial insurance (HMO)
is going to receive monthly zometa inj. also he has medi-cal (we did not know) and he wants to use medi-cal instead of his commercial insurance. Medical group already approved injections. Which insurance we are to bill as primary?

Thank you,

 

[Herbie Lorona]

Pt would most likely still need to use his commercial insurance as primary. Most of the time the Medicaid will show that the patient has a primary insurance and wont cover unless you bill the primary insurance first.

 

[dclark7]

Medicaid is always the payer of last resort. If the patient has a commercial insurance they are primary and the patient cannot elect, choose or otherwise decide to use Medicaid instead of their commercial insurance. If Medicaid is not aware of the commercial insurance and you know the patient has it you are obligated to provide the information on the commercial insurance (or liability in case of an accident) to Medicaid.

 

[rosa123]

Thank you.