Secondary Insurance

Because of the practice of 'Coordination of Benefits' our office no longer files secondary insurance claims. Basically, what coordination of benefits involves is a reduction of benefits from the secondary insurance by the amount received from the primary insurance. Here is how it works.

You first file a claim with the primary insurance company. Once the claim is settled you will be sent an Explanation of Benefits (EOB). You can now file a claim with your secondary insurance company. You fill out a claim form and then staple a copy of the primary EOB to it and mail it in. The secondary calculates benefits as if they were the primary and then subtract the settlement amount of the primary from the amount of benefits they calculated. If this difference is positive then they mail out a settlement in this amount, otherwise no benefits are provided ( i.e. a lot of time and paperwork without a payment). This process rarely result in more than $20.00 in benefits and most of the time no benefits at all. This is because the coverage provided by the plans involved are basically the same with no significate differences.

The only time a secondary insurance will provide significate benefits is when the primary is maxed. In this situation the amount subtracted by the secondary will be zero. This is the one situation were our office will submit a secondary claim for a patient.