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Can a Primary insurance contractual adjustment be billed to secondary insurance?

September 27, 2024 by Anonymous

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  • Can a Primary insurance contractual adjustment be billed to secondary insurance?

Can a Primary insurance contractual adjustment be billed to secondary insurance?

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If I send a claim to a primary insurance and they pay a portion and have a contractual adjustment that covers the remaining portion of the balance leaving no patient balance, is it appropriate to send the claim to the patients secondary insurance hoping they’ll pay what the primary adjusted off, or should the claim only be sent to secondary if the patient has a balance?

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Posted by Ericj63
Asked on September 27, 2024 7:50 am
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You still have to file the secondary claim. Most PPOs require you to file for any service provided (verify by reading the ins specific processing manual). Additionally, payments between both policies could pay up to your UCR and reduce your write offs.
(Jenny at September 27, 2024 1:42 pm)
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Hello! The patient's secondary insurance always needs to be billed to ensure accurate procedure history, regardless of the amount of the primary insurance's payment. Hope this helps!!

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Posted by Austinida
Answered on April 8, 2025 2:15 pm
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