Rank: New Member
Joined: 2/12/2018(UTC)
Posts: 8
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I have a patient with Medicare as primary and BCBS as his secondary medical. We don't participate with Medicare, but BC won't pay because they say they need primary EOB. I was told I could submit the claim back to BC by using modifer GA and having my patient fill out the ABN for non-covered services since Medicare likely would not pay anyway.
My claim came back denied again with the same reason. Any ideas?
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi tcfd1vldg!
Great question. It can be very difficult to get a secondary payer to reimburse anything before the primary insurer does, as those secondary's are designed to process after primary insurance.
However, we have had some practices report limited success in getting an insurer that is secondary to Medicare to chip in and process the secondary without the primary EOB, by either send a copy of your Medicare opt out letter and explaining that you cannot provide a primary EOB because you are opted out of Medicare and cannot send them a claim. Of course this isn't fool proof, but I have had some practices tell me it worked for them.
Hope this helps!
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