J S asked:


I need to know how to bill a patient who has both primary and secondary dental insurance. Is the patient’s co-pay limited to the primary carrier’s contracted amount or, because of the secondary, would they owe the full doctor’s fee? If the secondary carrier’s payment doesn’t fully cover the patient’s co-pay portion, what amount is the patient then responsible for? If the provider is bound to the primary carrier’s contracted fee, regardless of what the secondary allows, does any remaining charge exceeding that contratced amount get written off? If the patient has deductibles on both plans, do they owe both deductibles? If I have left out any relevant questions, any and all pertinent information would be most helpful. Thank you.

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Popple asked:


This is making my husband and myself crazy! I am 6 months pregnant and the Insurance Handbook clearly states that all my prenatal care is covered, with the exception on the initial $30 co-pay at the first visit.

Here’s the problem:
My doctors office is called OBBYN Affilates and has 6 doctors. They registered with our insurance (Conventry Health) under the individual doctors names. When you search for a provider, it lists all 6 doctors as covered, but no where says OBGYN Offilates.

The billing office for the doctor keeps submitting claims under OBGYN Offilates, which is not recongnized by the insurance because this is not how they registered. So, we are getting charged a much higher out-of-network rate. The billing office is very rude and states that this is how they have always submitted there claims: OBGYN Offilates w/ the doctors name underneath. However, when looking at our claims on line, it does not say the doctors name anywhere and they are all denied with us owing a large portion. They wont even cover my routine ultrasound!

However, all my prenatal refills at the pharmacy are under the doctors name and they are approved!

We left a message for the office manager at my doctors office and are waiting for a call back. I already called them once and they did nothing.

I am really worried about the hospital bill if this is messed up now!

Any ideas on how to get this fixed? It is such a stupid problem, but no one will cooperate!

Thanks!
Yes, I wish knew this sooner! I had my first prenatal visit in May, but didnt start getting bills until the first of August and I was already out of my first trimester.

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mna asked:


Like, you go to the hospital, give them your card, then what? I need a very detailed explanation please, including the names of forms used, rules, etc.

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niarobe asked:


I am trying to start a business & want to know every aspect of it so I won’t get ripped off in anyway. Don’t want to go to school to learn it, just want a few details on it.
not looking to do it myself, I am the owner, just want to know a little about it so when I hire someone to do it I will know something about it. Looking for basic info so I can ask the person certain questions so I can tell if they really know what they are doing.

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drums626 asked:


Does an insurance bill have to be sent in on the exact day its due, or is there a grace period of a week generally? What is it usually, since I know every insurance company is different? Thanks!

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