cgaston, I discussed both cases, if this was a medigap or if this was a secondary insurance.
Either case, processes the claim based on the primary remittance advice. There is something wrong with the processing of the secondary insurance that does not process their payment in context of the primary payment and what the remittance advice says, which has the allowable, paid amount and patient responsibility. Secondary insurances are only supposed to pay up to what the primary did not pay based on that remittance advice. If they paid more, be prepared for a refund request. And if they paid more, you have unearned funds that if not returned to the payer will be required to be escheated to the state. (As I indicated in my posting before). Secondary insurance is still secondary to the primary, tied to the primary’s remittance.