Should I Pay This Bill?
Skilled Care/Insurance Company Sold
I Have Medicare Plus One Medicare Supplement, Yet I Still Pay Bills?
WhyDo I Need CSA When My Doctor Files All My Claims?
I Have Multiple Insurance Companies, Yet I Still Pay Bills?
Why Was My Claim Rejected By My Primary and/or Secondary Insurance?
Should I pay this bill?
Never, never pay any bills until you are absolutely positive all of your appropriate insurance claims have been filed and
processed correctly. Providers often bill prematurely, even though, they know your insurance is still pending.
I have Medicare plus one Medicare supplement, yet I still pay bills?
Your provider might not be filing your secondary insurance for you. Another reason , the provider bills you before all of your
insurance is processed and you do not realize payment is still pending. Yet a third explanation exists; your provider does not
accept Medicare Assignment and your supplement policy does not pay the full amount disallowed by Medicare.
I have multiple insurance companies, yet I still pay bills?
The provider may very well be pocketing your money. About the only times you should pay bills with multiple insurance
companies or supplements are when your deductible has not been met or services provided are not covered under your
policies (i.e. refraction exams). Don't assume that your provider is filing your claims to all of your insurance companies. If he
does not file to multiple companies, you need to file them yourself. If the provider is filing the claim to all your companies, he
is probably being paid directly from the insurance company and not providing you with a refund of the excess reimbursement.
If you are on Medicare, chances are one of your policies is an automatic Medicare crossover and the other(s) are filed by your
provider. What happens is your provider gets paid by Medicare and the supplements. You are entitled to collect the extra
amount(s) from your additional insurances. A credit balance on your provider's account is not sufficient. A refund
check should be issued to you. CSA has often found that provider's claim to be unaware of this overpayment problem.
Why was my claim rejected by my primary and/or secondary insurance?
The simple answer is not all services are covered by all policies. However, many reasons do exist for an inappropriately
rejected claim. They include: wrong diagnosis code submitted by provider, proper documentation was not included, forms filled
out incorrectly, secondary insurance was thought to be primary insurance and vice versa.
Why do I need CSA when my doctor files all my claims?
Filing the claim is only one small step in the entire process. Often the provider mails you bills with balances due, even though
the balance is pending the insurance payments. Patients, thinking their insurance already paid, will go ahead and pay the bill
anyway. Remember, even after your insurance paid, it may not have paid the correct amount. Also, your provider, might not
be filing to all of your insurance companies.
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