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If the patient has Medicare as a secondary, yes. If the secondary is a state Medicaid plan, you most likely have to file it. I would advise you check your state's guidelines. As far as commercial plans go, you may want to check your individual contracts. Filing secondaries does yield more revenue, money that your patients would otherwise have to pay out of their pockets. Wouldn't you rather the insurance companies pay? You should carefully weigh these options, as your patients can very well take their business to another provider, who will file their secondary.