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Is medicare advantage primary or secondary!
Medicare secondary payer rules
What to know when Medicare becomes a secondary payer
A healthcare professional will collect primary insurance information from a person and then usually send an invoice directly to the insurer. For this reason, healthcare professionals need to have access to an individual’s insurance details.
Claims will be submitted to the primary insurer first.
Depending on the insurer’s rules, and if they do not directly bill the insurer, a person may need to complete a form online or mail in a claim form. The primary insurer then processes the claim per plan benefits.
When Medicare is a secondary payer, the primary insurer needs to report the claim status to Medicare for their consideration.
If the primary payer does not pay claims within roughly 120 days, the healthcare professional may send a bill to the secondary insurer.
If this is Medicare, Medicare may make a conditional payment, which Medicare then recovers from the primary insurer.
The rules surrounding Medicare as a secondary payer depend on a person’s primary insurance company.
An individual may contact the Benefits
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