Wiki WHO IS NUMBER ONE?

[romero033@outlook.com]

What do you do if two different insurance companies file as primary insurer and neither will take second place as the secondary insurer? The patient and facility have tried to get an answer but they both will not budge. How do I reimburse the overpayment?

 

[rthomas@impcna.com]

What do you do if two different insurance companies file as primary insurer and neither will take second place as the secondary insurer? The patient and facility have tried to get an answer but they both will not budge. How do I reimburse the overpayment?

Most companies use the birthday rule to determine who is primary when it comes to a child's coverage. Example: Mom's birthday is in June and Dad's birthday is in March. Since dad's birthday falls first in the year his coverage would be primary.
As for an adult there are several scenarios. Most of the time is the patient is employed and has coverage through their employer that will be primary. If Medicare is involved the Medicare portal will indicate who is primary.
What is the situation you are facing and I will be glad to help?

 

[romero033@outlook.com]

Thank you for pointing me in the right direction. We were working with a commercial plan and a Medicare advantage plan. I called Medicare and the private insurance should notify Medicare about the additional insurance.