Are health care providers obligated to accept payment from a secondary insurance at their fee schedule when the provider does not participate with the the patient's primary insurance?
It has been my experience that providers of health care are not obligated to accept secondary or even primary insurnace coverages if they are not under contract with that insurance company. I believe they are free to accept no insurance coverage at all and demand "cash" up front if they so desire. This would leave it your responsibility to sent the bill to your insurance(s) carrier(s) and get direct payment assuming they cover out of panel care. Some providers can not refuse you care even if you had no insurance but you would be responsible for the cost of care.
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Can the secondary insurance provider deny a claim that was not filed with the primary insurance provider first?
\n. \n Answer \n. \nLet me tell you what happend to me. I hope that this helps. I used to be covered by two insurance companies. My primary insurance company was throug…h the company that I worked with. My secondary was with the company that my husband works with. When a claim was filed with my secondary insurance company they wanted to know how much my primary insurance company paid for and until then they would not pay anything. So I had to submit to my primary insurance company and once they paid some then the secondary would. I hope that this helped:)\n. \n . \n Yes.\n. \nA claim must always be made with the primary insurer first.
Are health care providers obligated to accept payment from a secondary insurance with whom they participate when the provider does not participate with the patient's primary insurance?
Yes they will have to accept payment from the secondary insurance, however they will have to bill the primary provider first.. What ever the primary insurance does not cover …should be covered by the secondary insurance.. However, it will depend on the service being provided and the contracted amount that each insurance has agreed to pay.. If the primary pays more than the secondary would have paid -there may be a refund due.. However, there may be co-pays and deductibles to be met with both insurance policies.. There could also be write downs--- you should only pay the lesser amount. the provider may have to take a loss if one insurance has a lower contracted amount
If a health care provider accepts Indiana Comprehensive Health Insurance it cannot bill the patient correct?
After the claim is processed the patient will be responsible for any coinsurance, deductible; and any of the insurance companies non-covered services that were rendered.. Hop…e this helps!. Evan
You could have two insurance companies pay the same medical bill or claim for a date of service through a process of subrogation where the first insurance company determined b…y the effective date of coverage will pay their portion of the bill and the second insurance company will pay the balance. This process is called coordination of benefits. Secondary medical insurance is a second level of insurance coverage. Under most circumstances, the two policies are independent of each other. One policy may pay for a service while the other may not. The primary policy must pay first, then the secondary. The choice of which policy is primary or secondary is established by a shared rule between insurance companies. It is not the policy holder's choice. Examples of Primary/Secondary coverage: A husband and wife both work and carry the medical insurance offered by their respective employers. The husband adds his wife to his policy. The wife adds her husband to her policy. Under most circumstances, the husband's plan would be his primary policy and his wife's plan would be his secondary policy. In like manner, the wife's plan would be her primary policy and her husband's plan would be her secondary policy. Secondary insurance should not be confused with supplemental insurance. Supplemental policies usually abide by the primary insurance guidelines. If the primary allows the charge, the supplemental will allow the charge. Most supplemental policies cover the charges you would normally pay out of pocket. For example: A Medicare supplemental policy would cover the 20% coinsurance left over after Medicare pays 80% of the allowed amount.
Yes, and you want them to because if they are paid out of order then it will be a mess to correct.
As a provider i file primary insurance. do I have to also file secondary insurance after primary pays?
You should or you customer WILL be PISSED for having to do the leg work of getting the information of what the primary paid and getting it to their secondary.
Can medical providers decide to refuse to accept health insurance benefits after benefits were applied to a patient's account?
They cannot refuse "after-the-fact."
yes, they will treat it as if the primary was a different company. You pay two premiums. If they do not, contact the DOI.
No. Not if the employer is not set up to offer it to any of his/her employees OR if the company does offer it and you are a 'Part-time employee' working under 35 hours a week …OR if you are a 'Full-time employee' and have not worked for the company for 90 days.
When other insurers are initially liable for payment on a medical service or supply provided to a patient Medicare classifies them as the -----payer medicare secondary primary secondary or supplement?
Nobody has to take insurance if they don't want to.
Absolutely. I'm not sure what type of insurance you are talking about in particular but you are always required to tell insurance companies of other carriers that may have som…e liability in a claim. It is illegal to make money from a claim in this manner. Be very careful about items like this that can get you into a great deal of trouble with a felony charge of insurance fraud.
yes health care insurance provide dental coverage i think well maybe i dont know why are you asking me whyyyyyyy holy mother bejesus stop asking me thank you for asking me
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The services and products which are listed as provided by United Health Care Insurance are Prevention and Wellness, Utilization Management, Disease Management Solutions, Perso…nal Health/Care Management and Advanced Illness Services.
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Where the health care service is provided by the govt. as in U.S,the citizens covered under the scheme, are to undergo treatment atgovt. sponsored network hospitals and the ex…penses borne areprovided by the govt to the service providers. Whereas in Indiawhere you are to buy health insurance policy,get yourself treatedat network hospitals for free. The health service providers arecompensated by the insurance company. For treatment at non networkhopistals, the patient party are to meet up the hospital bill andapply for reimbursement from TPA with requisite papers, the laterin turn are compensated by insurance cos. at periodic interval.
Secondary health care providers are medical specialists withspecific expertise that your primary care provider will refer youto.