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Tag Archives: secondary

OB Experts Read!!Ob care and Delivery. Commercial primary and Medicaid secondary

Posted on by
Hello guys!

Any guidance is highly appreciated. If a patient has commercial insurance as primary and Medicaid secondary. How would you bill their OB care and delivery. Commercial bills global codes but Medicaid does not. Reason I ask is because she has a deductible with her primary but Medicaid will not cover the codes we bill to commercial if we were to forward the claim to Medicaid. Please advise! I am so confused!

Medical Billing and Coding Forum

Billing OB Care and Delivery when Patient has Commercial Primary Medicaid Secondary

Posted on by
Hello everyone!

I have not done OB/GYN specialty for long and having some confusion with this scenario. I have a patient who has Aetna as their commercial but has Medicaid as secondary. She has a deductible to be met on her Aetna policy and I know Medicaid will not pick up the codes that will be billed to Aetna for the global delivery. What is the proper way to bill this? Please advise!

Medical Billing and Coding Forum

Medicaid as primary or secondary- Can we charge the patient if they dont pay?

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if a patient has Medicaid as secondary can we trasnfer the balance to the patient if Medicaid does not pay? Because I know if the pateint has MEdicaid we can’t trasnfer the balance to the patient; however, if Medicaid does not pay is it still okay to charge the patient the balance? not sure if that applies when its primary and secondary or only primary.

Medical Billing and Coding Forum

submitting claims to primary commercial ins and secondary ins medicaid

Posted on by
I have a co-worker who insists that when 99395 is submitted to the primary commercial ins and denied, that the 99395 code can be changed to a 99214 to submit to the secondary ins medicaid plan first to receive payment. I thought this was illegal but I would like to find some information to print off regarding guidelines on this.
Any help would be appreciated.

Judy in Mobile

Medical Billing and Coding Forum

Medicare primary and we are out-of-network with secondary

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If the secondary payer does not pay because we are out-of-network with them (either they deny the claim or apply it to a large out-of-network deductible), are we allowed to write off the co-insurance since the patient would not have had to pay it if we had been in-network with the secondary?

Medical Billing and Coding Forum

Medicare Part C as primary/Medicaid Secondary

Posted on by
Needing some help –
We are seeing a patient with a UHC medicare advantage part C plan as their primary insurance, with Medicaid QMB as secondary. We participate with the patient’s primary, but are OON with all medicaid. I was under the impression with Medicaid QMB we cannot bill the patient for their copay, but now he has an upcoming surgery I am concerned will not be paid.
As far as billing, what is the best way to approach this? Can we bill the patient their copay if we let them know in advance?

Thanks in advance!

Medical Billing and Coding Forum