Primary insurance pays partially and assigns coinsurance as patient responsibility on the EOB. The patient also has secondary coverage. What is the correct financial next step?
Select an answer to reveal the explanation.
Short Explanation
Partial pay plus coinsurance is normal plumbing, not a crisis. Park the primary payment and adjustments, then send what’s left down the right pipe—secondary first if they have it, otherwise the patient per the plan. Skipping secondary or tossing everything to collections early leaves money and goodwill on the table.
Full Explanation
After primary adjudication, practices should post payments and contractual adjustments accurately, then pursue remaining responsibility according to coordination-of-benefits rules. When secondary coverage exists, bill the secondary payer for applicable patient responsibility before or in coordination with patient billing as the plan requires. Automatic write-offs, premature collections of the full charge, or ignoring responsibility fields create incorrect accounts receivable handling.