Need desperate help in regards to Secondary Kaiser insurance plan vs Primary plan

Hey everyone I am in desperate need of assistance in regards to my current insurance coverage. I have two insurance plans, Sutter Health Plus as my from my employer and Kaiser as my secondary through my father.

I have an upcoming surgery on Monday through my secondary Kaiser. I had no idea coordination of benefits was a thing until earlier this week. I made sure to get both insurances Coordination of benefits on file and have been calling them both all week to figure out if my surgery will be covered for sure.

Both Kaiser and Sutter health are telling me that all I need to do is showe both my Sutter Health card and my Kaiser card and tell them to bill sutter as primary and Kaiser as secondary. I'm under the impression that Sutter will deny it right away due to no prior authorization and being out of Network. I was told that Kaiser would then jump in pay the remainder.

I never bothered seeing Sutter health for this problem at all as I was already seeing Kaiser prior to starting kaiser and Kaiser is probably 5 of 100 plans that covers my procedure, no one else usually does.

But when I asked about Non-Primary clauses for Kaiser or Sutter health no one could give me a forsure answer on whether that is a thing or not and that in that case I may be potentially charged. I couldn't find anything regarding a non primary cause in my Kaiser insurance. I don't seem to have a pre authorization for the survey but I'm not sure if kaiser does those as this procedure is in network for them and I was already told that my insurance will cover it.

See also  will my work insurance reimburse me?

Does anyone have any experience in this type of scenario? Any input is appreciated, I have only a day left to call around so I want to make sure that I can proceed on Monday.

submitted by /u/ReallyInTheMix
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