Question Primary & secondary copay COB

[lindsey@foxworthbilling.net]

If a patient has primary and secondary commercial insurance plans, can the secondary insurer require the patient to pay the secondary copay? In this instance, the secondary insurance carrier is contracted at a higher rate with the provider.
EX. Primary copay is $30, but the contracted rate is $110.30. Secondary remit acknowledges the primary payment, pays the primary copay of $30, but leaves a $40 patient responsibility because the secondary contracted rate is $114.01.

 

[sls314]

If a patient has primary and secondary commercial insurance plans, can the secondary insurer require the patient to pay the secondary copay? In this instance, the secondary insurance carrier is contracted at a higher rate with the provider.
EX. Primary copay is $30, but the contracted rate is $110.30. Secondary remit acknowledges the primary payment, pays the primary copay of $30, but leaves a $40 patient responsibility because the secondary contracted rate is $114.01.

If the primary plan had a copay of $30 and the secondary payer made payment of $30, I'd consider the account resolved.

The patient doesn't have 2 copays just because they have 2 insurance plans.