 Is credit used in determining health insurance rates? |
| I am licensed in GA for property & casualty insurance, so I know credit is used to help determine rates for auto & homeowners insurance, but it is considered in health insurance?... |
|
 Best health insurance for young single people? |
| I'm looking for informaiton about health insurance for a single, young man...he is 27. Are there any affordable policies out there that may provide minimal coverage (annual well visit, a couple ... |
|
 Where can I find the best health insurance for the whole family.? |
| I want to get health insurance for my whole family, without going broke. My employer offers insurance but I don't like the provider. I want to be able to pay, out of my own pocket. Help anybody.... |
|
 Insurance and prescription benefits for a student?? |
| I am a full time college student, living on my own, with asthma, migraines and ADD. I don't have any benefits, and I was wondering if anyone knows how a full time student can get good ... |
|
 Homeowner's insurance? |
| My house is now worth substantially more than it was when I purchased it a few years ago. At the time of purchase, I had the house insured for the appraised value. Now it is worth tens of thousands ... |
|
 How do I find a certain life insurance company? |
| I am looking for National Fidelity Life Insurance.... |
|
 Insurance Help? |
| Well, I bought my son (16) a New 2008 Toyota Corolla S. I want to add him to my insurance. Well, the problem is that the insurance companies are asking for more than $400 a month, which simply I ... |
|
 I fell thru the stairs at my cousins house and broke my foot, and he won't give me his insurance info? |
| some of the stairs inside his house are missing. i didn't know and he didn't say anything about it, and i fell thru the stairs. I asked for his insurance info but he refuses to give it to ... |
|
| What is the best way to compare Medicare private plans available to me? |
in terms of premiums, coverage, deductibles, etc. thanks
Additional Details
yeah, no kidding, i should use a grid chart -- how about saying something that's actually helpful? ... |
|
| My husband is on worker's comp but what happens if he (god forbid) passes away? |
| Does a wife continue to receive her husband's disability payments on his behalf or does it just dry up when the injured spouse has passed away? I've tried to contact Worker's Comp but ... |
|
 Who is required by law to have workers compensation insurance? |
| My husband is starting up a company in Georgia and he will be the one and only employee. He's a wood finisher. (painter)... |
|
 If I spent the money the insurance sent me for the doctor bill instead? |
| In the state of California, what law is there that I can get in trouble with if I spent the money my insurance sent me to pay the doctor instead of paying him?... |
|
 Are Insurance Companies, the worst people to work with ? |
| Recently my town was hit with heavy rain and parts of it was flooded, my street was under water and started to come into my house, luckily just my floor was ruined and not anything else and had house ... |
|
 How could i get health insurance when i only work part time......??? |
| i work at albertsons....part time...they start everyone out there at part time...so i can't really get up to 40 hours a week now...and i don't know when i can work more hours...i really ... |
|
 Is it possible for someone to collect on a life insurance policy to which I am the beneficiary.? |
| The insurance ocmpany says they cannot find the policy and I wonder if my half brother could have done anything.... |
|
 I have a question about life insurance. ? |
| I want to get life insurance with AAA. Now when you get life insurance does that cover everything. For example car accident, sickness...etc. Or is there like we only give you the money if he dies a ... |
|
|  |
lilacs | Doctors billing primary & secondary ins company for same amount? |
Husband's surgeon billed our primary and secondary ins co's the same amt. We had been told previously that the secondary would be billed for only what the primary did not pay. Is this right? Sounds like they are really trying to get 100% of what they are charging as both ins co's disallowed a portion.
Cardiac dr said they bill primary and what ever is not paid they bill that portion to the secondary.
Anyone have any insight into this?
Thank you. |
 |
 
sarah314
|
They are required to bill the same total billed charge to both insurance companies. This is probably what's confusing you.
When the secondary insurance company processes the claim, they don't go by the total number reflected on the bill to determine what they will pay - they use the Explanation of Benefits from the primary carrier to pay the leftover balance.
The reason that the actual bill to the secondary insurance company has to be for the same dollar amount that was billed to the primary is to make it easier to process and to know that they were being billed for the same services.
I've processed secondary claims before - you look at the total charges on the bill and compare them to the total charges on the primary carrier's Explanation of Benefits. If they don't match, you send the claim back and ask for a bill showing the same charges that were billed to the primary. Its standard procedure.
(Then you compare the bill to the Explanation of Benefits, look at any amounts that the provider is contractually obligated to write off for the primary, etc. When the secondary insurance processes the claim, they take a look only at the portion that was left as "patient responsibility" after the primary processed it.)
Sounds confusing, I know...unless you've handled the situation hundreds of times before. :) But, it sounds like the cardiologist's billing people did exactly what they were supposed to do. |
|
Jan C
|
This is called coordination of benefits. Both insurance Companies are aware who the primary is and who the secondary is. This is common practice. Carefully look at the Explanation of Benefits (EOB) when they come in showing what was paid. If in either situation, the correct amount was not paid by either, you have full rights to inquire and get a clear and correct answer to this. Hope this helps. Good luck. |
|
BluedogGirl
|
The insurance companies will figure ths out and only pay what they need to pay. They know who is primary and the secondary company will not pay until they know what the primary company paid.
If the surgeon is overpaid, if he/she is ethical, the office will return the overpayment.
Most doctors are ethical, a few are not. |
|
Barry auh2o
 |
For accounting purposes he has to bill both ins co's the same amount. However,when billing thesecondary ins, he has to show what hte primary ins paid.
This is coordination of benefits,
By the way, I'm glad you aretaking an interest in this. Too many people figure " I have ins,what do I care."
This has caused a lot of problems we have today.
Both co's should send you an explanation for what they paid. and you should review this carefully.
I hope yoiur husband's surgery was successfull and he is on the road to recovery. |
|
nikki
 |
OK .. here's how it goes ... if they are concerned about timely filing issues or not clear over which one is your primary insurance they will bill the two the same ... however for your secondary insurance to pay they must receive a eob (explanation of benefits) showing what the primary paid along with the insurance claim... they do this to insure there will not be any double dipping... |
|
Jon
|
I think medical billing is one of the biggest scams going on today. Most people don't care, as long as they are not paying the bills, so they don't even look at the bills, and each insurance company doesn't know what the other company is paying.
By Father-in-law, was on his death bed,(he dies a few hours later) and they wanted to start Chemotherapy on him. Hey if you get one douse in him, you can charge it.
We also were getting NEW bill for his short (4 days) a year later. How are we suppose to tell if these are legit charges. |
|
mama29
|
Yes. I work in a medical office and can tell you that your Dr. is correct in the primary ins. should pay its part and only what is not paid by primary is supposed to be paid by secondary. Many big companies do whatever they think they can get away with- call your ins. companies and inform them of what is happening. They will make short work of it and will appreciate you notifying them of the problem. |
|
vergie56
|
i have primary and secondary insurance. i had my second knee replacement in two years. both times my secondary insurance only paid $200.00 or less. they come back with your primary paid the most allowable for this charge?? |
|
| |
|
| | |
| Questions List |
Answers | Last Post
| | | |
7 | 35 minutes(s) ago
| | | |
7 | 2 hour(s) ago
| | | |
7 | 7 hour(s) ago
| | | |
7 | 11 hour(s) ago
| | | |
7 | 2 day(s) ago
| | | |
7 | 5 day(s) ago
| | | |
7 | 1 week(s) ago
| | | |
7 | 3 week(s) ago
| | | |
7 | 1 month(s) ago
| | | |
5 | 2 month(s) ago
| |
|
Homepage 
Financial
Forum 
Insurance 
No Spam
Adult 
Gambling
Unfinished
Deception
Plagiarism
Not English
