Dual Coverage for me is great but not for Husband and Son
Hey Y’all, I’m fairly well versed in medical billing but haven’t been a biller in about 10 years so a bit rusty. My husband and I are double covered for insurance as well as our son. When I have a claim whatever is remaining from my primary insurance, my secondary picks up and I never have to pay anything.
When my son has a claim, there’s usually very little left to pay from the primary but his secondary is not picking up anything after. I hate Anthem’s EOB because they don’t use actual terminology you would see in a remit, they use “patient friendly language” which masks what is actually going on. Case My son’s primary paid and all that was left was a $25 co pay. Office Visit Total Charges $199.94 Your discount: $66.83 Due to your doctor: $133.31 Other insurance paid: $128.38 They paid 0.00 and said HealthPartners paid $128.38 and we subtracted that from our payment Amount you owe: $4.93 and they applied it to the co-pay column when my plan is not a co-pay plan.
How come they are not processing the claim with amount due to doctor as $25 and charging me the 20% co-insurance? What language should I be looking for in my plan to understand how they are processing as secondary. It’s like they are processing as primary but they aren’t.
