AAPC - Back to school
Results 1 to 7 of 7

Thread: Medicare as Secondary

  1. #1
    Join Date
    Apr 2007

    Question Medicare as Secondary

    AAPC: Back to School
    Hi everyone! I have a pt that has commercial ins as primary and Medicare as secondary. Pt has a balance left over after primary pmt that was billed to medicare, medicare did not cover full payment for the remaining balance the primary ins said the pt owes, can we bill the patient for the remainder minus what Medicare paid since it is still owed from the primary pmt. This is the first time I have experienced Medicare as a secondary payor.

  2. #2


    How would you get reimbursed for that amount owed after Medicare paid their part? You would have to bill the pt for the remaining balance.

  3. #3
    Join Date
    Apr 2007


    I said that we should bill the patient but I spoke with a different office and they said they always write it off, of which I thought was incorrect. Thanks, just need re-assurance that I can bill the patient.

  4. #4


    The Medicare remit should tell you the amount that you are able to bill the patient. If it says $0, you will need to w/o the difference. Medicare pays less than commercial insurances so if the primary paid more than what Medicare allows, they won't pay.

  5. #5


    If Medicare has allowed the charge and paid a partial amount and has not indicated that it is a write-off you can bill the patient.

  6. #6


    You can bill the patient only for the amount indicated on the remittance under co-insurance or deductible. Make sure your primary diagnosis was not phsych related. Medicare deducts for phsych related services.

  7. #7
    Join Date
    Apr 2007
    will join Pasadena,Ca

    Default Medicare as a secondary

    Since M/Care is a Secondary, Look at you RA and make note of CO-45 (Contractual Obligation W/off) and PR - 2 (Patient Responsibility COINS)..Once Medicare adjudicate the claim they will pay 80% of allowed amount and if PR -2 is listed that amount would be the patients responsibility.

Similar Threads

  1. Medicare Secondary
    By kanderson17 in forum Billing/Reimbursement
    Replies: 2
    Last Post: 09-11-2015, 10:38 AM
  2. Medicare Secondary
    By prusso in forum Billing/Reimbursement
    Replies: 5
    Last Post: 04-09-2014, 03:49 PM
  3. Medicare secondary
    By june616 in forum Medicare Regulations
    Replies: 3
    Last Post: 02-12-2014, 02:54 PM
  4. Medicare secondary
    By jalexander in forum Medicare Regulations
    Replies: 2
    Last Post: 07-17-2012, 07:55 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.