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Is the patient responsible for deductible and coinsurance if primary insurance paid more than secondary would have allowed.
When the insured/beneficiary (patient) pays the total deductible amount out of his own pocket. A deductible is the amount for which the patient is financially responsible before an insurance policy provides payment.
If the provider is out of network or not contracted with the secondary insurance, they do no have to bill the secondary and the patient is responsible for the balance (if any) owing
Secondary insurance will not pay the claim but the remaining charges should not be billed to the member/patient. Provider of service should write off the patient responsibility that primary insurance applied.
That is if the secondary does not have a clause in it that "they will not duplicate benefits" If so they will not always pay the difference. They will figure out the amount they would normally pay, subtract what the primary pays from that amount and pay the difference (which with mine is little to nothing and I end up paying the balance of the bill) Nothing really happens, one is the primary and the other is the secondary insurance for the patient. Primary insurance will pay up to 80% of allowed charges if the deductible is met, and the secondary insurance will pay the remaining 20% of the claim, again, if the deductible for the year has been met.
nome
AnswerNo, the deductible is owed to the doctor or hospital. The insurance company doesn't care if you pay it or not. In most cases we'll have no idea whether or not you paid.
Secondary.
if primary paid more than allowed amount or if patient has primary insurance
yes
Yes it is patient responsibility
No; this is a copayment (or "copay"). A co-insurance is a percentage that the insured is responsible for after meeting their deductible.