Advertisement

Q&A: Billing a secondary insurance company

Published on: 

Get your questions answered on secondary insurance billing.

Q: Is a medical practice that has a contract with a patient's primary insurance company obligated to bill the patient's secondary insurance company? Also, must a practice accept what a secondary insurer chooses to pay, whether or not it has a contract, if the secondary insurer decides that the primary insurer already has paid an appropriate amount?

A: The answers to your questions depend on state law. Some states require physicians to bill all insurers a patient has, without charge, whereas others do not.

If the physician has a contract with the secondary insurer, then, by contract, he or she most likely is obligated to submit the bill. If the physician does not have such a contract, then he or she may be able to give the patient a copy of the bill and have the patient submit it for reimbursement.

Advertisement

Send your practice management questions to mepractice@advanstar.com. Answers to our readers' questions were provided by Judy Murray of Clayton L. Scroggins Associates, Cincinnati, and Steven I. Kern, JD, of Kern Augustine Conroy and Schoppmann, Bridgewater, New Jersey.


Advertisement
Advertisement