iBoske | Denied - Other Insurance is Primary

Pankaj Joshi

How many insurances patient has got? 2 Insurances. 1 Insurance.
Send to client for calling patient. Patient has to update COB or should provide other coverage details to us.
Denial is from Primary or Secondary. Primary. Secondary.
Payor level as per secondary insurance? Secondary claims to be primary. Secondary claims to be secondary.
Send a request to client for calling patient. Patient should update COB with insurance.
Are we in time limit to submit claim to secondary? Yes. No.
Bill claim to actual primary carrier.
Patient provided information with delay / we did not check eligibility on time. Patient provided information with delay. We did not check eligibility on time.
Bill claim to insurance. Tag for appeal on receipt of denial for untimely submission..
Bill claim to insurance. Tag for adjustment approval request on receipt of untimely submission denial..
Primary insurance was billed. Yes. No.
Secondary insurance was billed with primary EOB? Yes. No.
Call secondary insurance for reprocessing the claim.
Are we in time limit to submit claim to secondary insurance with primary EOB? Yes. No.
Submit claim with primary EOB.
Patient's delay / Billing Error. Patient's Delay. Billing Error.
Bill claim with primary EOB and appeal on receipt of the denial.
Bill claim with primary EOB and send for adjustment approval on receipt of a denial.
Are we in time limit to submit the claim to primary insurance now? Yes. No.
Submit claim to primary insurance.
Patient provided correct information with delay or it is billing error on our part. Patient's Delay. Billing Error.
Bill claim to primary and appeal on receipt of the denial.
Bill claim to primary and send for adjustment approval on receipt of denial.