About LASHUNDA Expertise Billing,Claims, and resolutions to the following insurance agencies: Medicare, Medicaid, Coordination of Benefits, Most Managed Care such as HMO's, PPO's, Medicare Advantage Plans, Governmental Agencies such as Work Comp and Veteran's Administration. I would like questions that are in regards to Billing and Collections from Insurance Companies. I can also accept some questions regarding accounts sent to Medical Collections. Please be advised that I reside in Texas and most of my knowledge is based on how it works in Texas.
Experience I have worked in the Medical field for 15 years. I currently help to coordinate contracts for a physician group in Texas. I am extremely good with resolving issues with commerical insurance companies. I'm an expert in coordination of benefits between Medicare and Commercial insurance companies.
Question We billed a claim to patient Primary Payer and claim came back denied because the provider was out-of-network but they applied $108.72 towards patient deductible. Provider is contracted with Medicare but because it is listed as patients secondary payer will Medicare pick up the deductible or do we transfer balance to patient responsiblity?
Answer Hi Catherine. Thanks for the question. You should always bill all insurances available. As a fact, Medicare requires you to bill them for all services. After Medicare consider the claim you can bill the balance stated on the Medicare explanation of benefits.
