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General Surgery Coding Alert


Solve Secondary Payer Woes With Expert Answers

Rules determine who's primary and secondary.If you've ever been confused about submitting secondary payer claims, we can help with answers to three burning dual-payer billing questions that we've heard from our readers:Background: When a patient is covered by two insurance companies, such as patients whose employer and spouse's employer both provide health benefits, claims processing can be confusing. Add in differing payer claims processes and patients who might not give you all the information you need, and primary and secondary payer cases can lead to reimbursement loss -- not to mention biller headaches.You can maximize your surgeons' reimbursement and reduce the costs of administering claims for patients covered by more than one payer if you understand coordination of benefits (COB) and how both insurers are supposed to pay.Question 1: What Does Coordination of Benefits Mean?COB is a common clause in many health insurance policies. It specifies how the insurer will [...]