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It has been my experience that providers of health care are not obligated to accept secondary or even primary insurnace coverages if they are not under contract with that insurance company. I believe they are free to accept no insurance coverage at all and demand "cash" up front if they so desire. This would leave it your responsibility to sent the bill to your insurance(s) carrier(s) and get direct payment assuming they cover out of panel care. Some providers can not refuse you care even if you had no insurance but you would be responsible for the cost of care.

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Q: Are health care providers obligated to accept payment from a secondary insurance at their fee schedule when the provider does not participate with the the patient's primary insurance?
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Related questions

Are health care providers obligated to accept payment from a secondary insurance with whom they participate when the provider does not participate with the patient's primary insurance?

Yes they will have to accept payment from the secondary insurance, however they will have to bill the primary provider first. What ever the primary insurance does not cover should be covered by the secondary insurance. However, it will depend on the service being provided and the contracted amount that each insurance has agreed to pay. If the primary pays more than the secondary would have paid -there may be a refund due. However, there may be co-pays and deductibles to be met with both insurance policies. There could also be write downs--- you should only pay the lesser amount the provider may have to take a loss if one insurance has a lower contracted amount


With Primary and Secondary Insurance your primary denied your claim because it was over a year is your secondary obligated to pay?

Yes, subject to the limits in their policy. No. With most insurance policies, there is what is called a timely filing limitation. For my company; contracted providers have 6 months, and non-contracted providers have 12 months to submit the claim. If your primary insurance received the claim within timely filing, you may have the option of submitting the claim to your secondary with proof that it was filed in a timely manner. If that doesn't work you can always appeal the decision with the secondary or for that matter the primary insurance company. Policy holders are not responsible for claims that deny for timely filing.


Who are primary and secondary providers in the hospitality industry?

Hotels and restaurants are examples of primary providers in the hospitality industry. Secondary providers include conference centers and nightclubs.


Will secondary insurance pay the co insurance amount of primary insurance if you have met the deductible in secondary insurance?

Yes


Secondary health care providers?

Secondary health care providers are medical specialists with specific expertise that your primary care provider will refer you to.


Are you obligated to tell your primary insurance about secondary insurance?

Absolutely. I'm not sure what type of insurance you are talking about in particular but you are always required to tell insurance companies of other carriers that may have some liability in a claim. It is illegal to make money from a claim in this manner. Be very careful about items like this that can get you into a great deal of trouble with a felony charge of insurance fraud.


Will secondary insurance cover claims denied by your primary insurance?

As long as it is a covered expense by your secondary insurance and a claim has been filed with the primarty insurance then the answer is yes. The secondary insurance will only cover the expense according to your plan.


Is your secondary insurance responsible for the part of the bill not paid by medicare?

Providers and hospitals that are in your insurance companies network will not come after the patient for costs over the negotiated allowed amount for the services they provide. Providers and hospitals can try to collect from you if they are not in the network (even if your insurance company has paid for some costs) or if some of the services are not covered by your insurance company, or if you are over the benefit limit for those services. Also, providers and hospitals can collect coinsurance costs that you haven't yet paid. If Medicare is secondary than unpaid costs would fall to them but the same rules apply. Potentially some services are not covered by either.


Does secondary insurance cover or pay copays of primary insurance?

The secondary insurance cover both pays and co-pays of the primary insurance depending with the insurance company.


Will secondary private insurance pay deductible from the primary insurance?

Some will. Check with the secondary insurer.


What do you do if your doctor does not submit to your secondary insurance and now its denied for timely filing?

appeal to secondary insurance


Does secondary private insurance pay what primary private insurance will not pay?

Yes, if the secondary insurance plan covers it In the pharmacy (drugs) world of primary and secondary coverage, this is true.