Coordination of Benefits question

I currently have an issue where one insurance (the secondary) is claiming there is a lower allowable expense than the primary which is resulting in me getting stuck with thousands in bills.

I have below an example of what I am talking about. This is only one bill of about 6.

Secondary COB Primary COB

Total billed: $16,366.80 $16,366.80

Allowable: $13,392.80 $16,366.80

Primary payout: $14,781.09 $14,781.09

This is causing me to get a $1585 when my understanding is the secondary insurance is supposed to pick up the difference (the $1585)

Has anyone dealt with this before and have any ideas how to resolve it?

I called the secondary and they said I can submit an appeal but we know how that goes.

I need the primary and secondary to agree on what the allowable expenses are.

Tomorrow I am going to request a breakdown of what they deemed allowable and not in these bills as they have not provided it.

Would it be worth my time to get an attorney? is there an advocacy group I can pay that will help me get this figured out?

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Thank you

submitted by /u/Riggs417
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