MEDICAL BILLING AND CODING

Friday, July 17, 2009

SECONDARY INSURANCE

When a patient has more than one insurance company, the insurance that is responsible for balance on a bill after the primary insurance has paid, is the secondary insurance. They will pay their portion of the bill based on what the primary has already paid. To determine their portion of the bill they will require a copy of the primary insurance’s EOB. For this reason, a secondary claim is always sent with a copy of the primary EOB.

PRIMARY INSURANCE

Many people in US have more than one insurance coverage. They may have up to three insurance coverage's. This is possible if one person is the subscribers to two policies, a person subscribes to one policy and is covered under his spouse’s coverage or the person may be a dependent of two working parents. In these cases, one insurance company takes first responsibility for the patient’s medical bills.it would pay major portion of the bill. This would be patient’s primary coverage.

WHAT IS TRICARE?

TRICARE is a regionally managed health care program for active duty and retired members of the uniformed services, their families, and survivors. TRICARE brings together the health care resources of the Army, Navy, and Air Force and supplements them with networks of civilian health care professionals to provide better access and high quality service while maintaining the capability to support military operations.

TRICARE is being phased in gradually on a nationwide, region-to-region basis to:
 Improve overall access to health care for
beneficiaries,
 Provide faster, more convenient access to civilian
health care,
 Create a more efficient way to receive health care,
 Offer enhanced services, including preventive care,
 Provide choices for health care, and
 Control escalating costs.

WHAT IS CHAMPVA?

CHAMPVA, the Civilian Health and Medical Program of the Veterans Administration, is a program by the Veterans Administration that shares the cost of medical bills of veterans with total or permanent service-connected disabilities with their spouses and children or surviving spouses or children of veterans who died as a result of service connected disabilities.

WHAT IS CHAMPUS?

CHAMPUS, the Civilian Health and Medical Program of the Uniformed Services, is a federally funded health care program that provides hospital and medical services to dependants of deceased or active duty service personnel, retired service personnel and their dependants, and Public Health Service Individuals.