DL HEALTH CLAIM SOLUTIONS, LLC - Your Medical Bill Advocate
RSS Follow Become a Fan

Delivered by FeedBurner

Most Popular Posts

Coding errors on medical bills
Health Insurance Benefits-Colonoscopies & Other Preventative Care
Update on Preventative Care
Dental claims for trauma to the mouth


Auto Insurance Medical Claims
COBRA issues
Coding Errors
Dental Claims
Early Intervention, Autistic Children
Health Insurance Benefits
Homeowner's Insurance Claims
Insurance payments
Medical Billing Servicves for Doctors
Mental Health Claims
More than One Insurance


November 2014
April 2014
January 2013
November 2012
October 2012
September 2012
May 2012
April 2012
January 2012
December 2010
November 2010

powered by

My Blog

Medicare/Secondary Insurance

This post is for people with Medicare and a secondary insurance that is NOT a Medigap policy. 
 Did you know that if you have medical services that are not covered by Medicare, but ARE covered by your secondary insurance, there is a certain way you must submit your bills to the insurance? Suppose your doctor is opted out of Medicare, so you have to pay him up front and he gives you a statement to submit yourself. You MUST complete a 1490S form, found on the Medicare website. Attach copies of the bills from your provider to this form. Write in big bold letters: FOR DENIAL ONLY across the top of the form. Mail it to Medicare so that they will create a Summary of Benefits for this service denying payment. Then you must take a copy of that summary from Medicare, a copy of the bill, and your secondary insurance claim form, and send it in to the secondary insurance.
If you do not first send it in to Medicare, your secondary insurance will either deny payment outright stating you must first bill Medicare, or they will pay against some arbitrary number they have dreamed up as the amount Medicare would have paid.
This whole process sounds complicated, but it is really about being organized and keeping copies of everything.