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Part B Insider (Multispecialty) Coding Alert

Guest Column:

The Facts You Need to Know About Primary vs. Secondary Coverages

Written by Steven M. Verno, CMBS, CMSCS, CEMCS, CPM-MCS Health care is not as simple as it used to be. Today, some patients have health care benefits through multiple insurance plans. I'm one of them. I have Medicare as my primary coverage and Tricare for Life as my secondary coverage. I make sure that every doctor that treats me is contracted or participating with each of my plans. If they don't, I look to find another doctor that does. What can become complicated is when the doctor is not contracted or participating with either insurance company. Things go ballistic when the doctor works in a hospital but the hospital is contracted and the doctor isn't, but that is the subject for a future article. You can add to the confusion when you factor in the type of health plan the patient has, and the laws that have jurisdiction over that [...]