tci Medicare Compliance & Reimbursement - 2012 Issue 3
Reader Question: Avoid Automatically Writing Off Secondary Insurance Deductibles
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Article Overview
This article explains a common billing question about secondary insurance, deductibles, and patient responsibility. It focuses on coordination of benefits, use of primary and secondary explanations of benefits, and how payer contracts affect balance handling. The content is aimed at billing and front-office staff who manage patient financial information and claims follow-up.
Why This Topic Matters
Secondary coverage can create confusion about what to bill, what to collect from the patient, and what should be left as a contractual adjustment. Clear handling of these situations helps practices avoid incorrect write-offs and reduce account errors.
What You Will Learn
- How secondary insurance affects patient balance handling
- Why primary coverage must be identified before billing secondary coverage
- How explanation of benefits documents are used in coordination of benefits
- How payer contracts influence responsibility for remaining balances
- General approaches to collecting patient cost-sharing at the time of service
Who Should Read This
- Medical billers
- Front-office staff
- Practice managers
- Revenue cycle staff
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