What should an EOB look like when coordinating benefits through two insurances?

I have two insurances – one primary UnitedHC from my work and one BCBS as a secondary plan through my husband’s job.

I saw a specialist for a visit in May and the visit was $262. According to my United EOB, the visit was discounted $162 to amount allowed of $99. I pay $50 copay and plan pays $49.

The provider is lax in submitted it to secondary, but I call them a couple of times and they say I owe $109, but they’ll let it slide and only charge me the $50 copay and check with my EOBs for details.

What should the EOB from my secondary look like? The provider is InNetwork for both insurances. BCBS specialist visits have a $110 copay listed on the insurance card. I called BCBS and they confirmed the provider billed the $262 and they paid out as Secondary, but that I was responsible for $103 as a copayment and $6 applied to the deductible. This matched the EOB.

Why would I be charged more OOP with two insurances for an office visit?

What words do I need to get this rectified? And who do I speak to, and in what order, to get it sorted?

submitted by /u/moon_of_blindness
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See also  QUEST FINALCIAL ASSISTANCE