I currently own a Unicare health insurance with a $50 copay and a $1,500 deductible. At the same time, I have a Family Care health insurance, a form of Illinois Medicaid, with a $5 copay. The Unicare serves as my primary health insurance and the Family Care as my secondary. My husband is currently undergoing physical therapy and the providers accepted both insurances. They are now billing my husband for a 40$ co-pay since according to them, they are physical therapist. Wasn’t it supposed to be that you have to bill the insurance first before billing the insured patient for the remaining amount?
However, this arrangement may change depending on the coverage stated in your policy. There are certain Unicare policies that don’t cover a $30 co-pay but rather $30 for each therapy visit, leaving the patient with the rest of the amount. Usually these policies only cover 12 visits. Moreover, there are also health providers that don’t recognize secondary insurance plans. In your case, only Unicare pay while you have to compensate for the remaining balance. You have to take note also that, physical therapy is somehow different from regular medical care. The policy rules for a regular medical practice may not apply to a physical therapy. It usually helps a lot to study the coverage of the Unicare and MedicAid policy you have regarding its provision for physical therapy coverage. You might as well contact these insurance companies to assist you in making this claim. Answer by general public - June 3, 2009 @ 2:53 pm No CommentsNo comments yet. Leave a comment |
|
Generally, billing for a service rendered to an insured patient should follow the pattern of billing the insurance first before billing the policy holder. Likewise, billing policy holders with a primary and secondary insurance follows the same procedure. That is, with the primary (Unicare) as the first to bill followed by the secondary (MedicAid) then the remaining amount should be taken care of by the insured patient. The insurance companies for both primary and secondary insurance are then required to submit an EOB (Explanation of Benefits) document reflecting the insurance’s contribution to the service pay (usually including co-pays) and the remaining balance.
