When to bill secondary insurance for ABA services?

[yanyos]

Can't say.

My wife was in the hospital late January. Her group plan is primary, Medicare A is secondary.

Took almost 3 months for the hospital to bill. I suspect they were waiting on Medicare since BX paid in a couple of weeks.

In your case it may not be the provider having trouble billing, but the secondary carrier will normally take several weeks to adjudicate the claim.

Okay my friend. Real case:

Primary Allowed 300 Deductible 80.02 Coinsurance 44.00 Paid: 175.98

Secondary: allowed amount is $216, why wouldn't we bill the secondary and try to get paid some of the deductible? If I'm understanding the math correctly we would get $40.02 (216-175.98=40.02)? and then we write off the 84 we can't collect. ?

 

[somarco]

Okay my friend. Real case:

Primary Allowed 300 Deductible 80.02 Coinsurance 44.00 Paid: 175.98

Secondary: allowed amount is $216, why wouldn't we bill the secondary and try to get paid some of the deductible? If I'm understanding the math correctly we would get $40.02 (216-175.98=40.02)? and then we write off the 84 we can't collect. ?

I am not sure what you mean by "allowed". But if primary said their "responsibility" was $300 (before deductible and coinsurance) and the secondary said their "responsibility was $216 the secondary will pay $0

Health insurance: How coordination of benefits works