Primary insurance adjustment billed to secondary insurance

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If I send a claim to a primary insurance and they pay a portion and have a contractual adjustment that covers the remaining portion of the balance leaving no patient balance, is it appropriate to send the claim to the patients secondary insurance hoping they’ll pay what the primary adjusted off, or should the claim only be sent to secondary if the patient has a balance?

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Asked on September 27, 2024
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The claim should be submitted to secondary insurance even if there is a remaining balance. It's crucial to ensure that the patient's primary and secondary insurance records accurately reflect their procedure history.

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Answered on April 8, 2025

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