Hi, I am hoping somebody can help with this scenario and also provide somewhere were I can find the proper documentation to support the decision:

Patient has commercial insurance A as primary, commercial insurance B as secondary. Provider is in network with both A and B.

Insurance A shows an allowable amount of $ 65, pays $ 55, patient responsibility is $ 10.
Insurance B shows an allowable amount of $ 100, pays $ 0 (applies to deductible), patient responsibility is $ 100.

Is provider supposed to bill the patient for the $ 10 per Insurance A patient responsibility,
or $ 100-$ 55 paid by insurance A=$ 45 per Insurance B.

Any help would be appreciated – as well as where I can find the documentation regarding this.

Thank you,

Susan Wood, CPC-A, CPB