I hope you can assist me with an issue we have gone back and forth with in our office. If a patient has a commercial policy & Medicaid managed care (Sunshine, Staywell, Prestige) policy as secondary, is the patient responsible for the co-pay & or deductible?

Example 1: We submit a claim to BCBS for $ 150. They apply the allowable of $ 100 to patient deductible, our contractual adj. is $ 50. We submit a secondary claim to Medicaid managed care plan. The Medicaid MMA pays their allowable $ 50. What happens to the other $ 50? Is it adjusted off as contractual adj under secondary or is it patient responsibility?

Example 2: We submit a claim to BCBS $ 150. They allow $ 100, $ 50 payment and $ 50 co-pay, our contractual adj. is the $ 50. We bill the Medicaid product $ 50 patient responsibility. The Medicaid MMA does not pay anything because primary paid over Medicaid allowable. Can we bill the patient for that $ 50 co pay balance.