Help!Covered by two health insurances and problem happened?
I have healthy insurance from my employer. My husband also has another covers me as a dependent. Both are PPO.
Recently my husband’s insurance billed us and said they are secondary insurance but paid as the first for all past bills on me. They are asking doctors to refund. If doctors do not refund, I will need to pay them back. Otherwise they will report to credit office.
I asked doctors to go to my first insurance to process these bills, However, the first insurance company said they have three month limits to submit the claims after services so they reject to cover old bills.
Most doctors just ignore what I asked(refund second and process first) because they already got money from the secondary company.
What can I do? My husband and I never recieve any information from secondary insurance about what is the first/second insurance before, even when enroll. They said it is my fault not knowing so I have to pay them.
Really worries..Any suggestons help! Thanks!
Thanks a lot for all your suggestions! Very helpful!
When I went to see the doctors. they took my insurance cards and made copies. They did not ask me to fill forms about insurance information.
The second insurance company processed bills which already showed other insurance coverage long time ago. They did not complain until recently. If they told me at that time, it would not be a violation of my first insurance’s 3 month policy. I think the second insurance do responsible for time delay, which leads to my first insurance deny. Am I right?
I also found there are doctors charged both insurance as the primary. I called them to refund to the second insurance but sounds like they do not want to handle that. One biller insists on they did not charge me secondary although my EOB on both insurances showed they charged. Another biller said they never recieved the money from the secondary insurance company although EOB showed that. What can I do in these cases?
Thanks!
Tags: can husband and wife have 2 health insurences, eob two health insurences, happened, Health, Health Insurance, HelpCovered, insurance car, Insurance Company, insurances, Problem
Something very similar happened to me last year. My company switched carriers and the old carrier was billed. They paid and noticed it 4 months later. The right carrier said they didn’t have to pay as the claim had to be filed within 90 days.
I got nowhere with a letter and then an appeal. First they said it needed to be filed within 90 days. After the 2nd appeal they said that I wasn’t covered during the time of the claim (I was covered). Calling seemed a waste of time as it seemed as if the people who answered the calls got pleasure out of telling me that I got the wrong department (after a 10 minute wait).
Finally I found my State’s department of insurance website. I filled out a very simple online form and voilia! What a surprise, after the insurance company received an official complaint, they admitted a “clerical error” and paid the claim.
I agree with Glenroid. Contact your state insurance office and see if there’s anything they can do to help.
In the future, when you first arrive at the office, give your provider your insurance card and tell them to bill only your insurance. Before you leave, ask your provider for a copy of the original bill. When your insurance has paid, you should recieve an eob (explanation of benefits), which you can then submit, with the original bill, to your husband’s insurance.
Depending on the state in which you live, your husband’s insurance may just be stuck with the bill.
I work at a pharmacy and I come across these things quite often. Usually if you have coverage on 2 insurances whichever one you are considered the cardholder that will be your primary. Then if you have another through your spouse that is your secondary. Because your husband put you on as dependant that became your secondary. I’m so sorry about your situation. If you’ve tried calling both ins. and explaining your situation and they’ve told you that the period of time to rebill has expired then I don’t think there’s anything else you can do. Which ins. is it? Can they send you some claim forms? I’m so sorry I wish I could tell you theres a way but I can’t think of any right now.
Well, when you went to the doctor, there’s places to fill out if you have more than one insurance company!! Did you do that??
I think you’re going to need some legal advice on this. Both insurers are correct. YOUR policy should be primary. Your HUSBAND’S insurer is entitled to reimbursement if they paid on a primary basis. And YOUR insurer is entitled to put in a time limit to submit any claims.
The doctors certainly aren’t going to pay back money for services rendered – that puts THEM in the position of having to sue you in court to get paid.
So although I RARELY recommend attorneys to get involved, I think you’re going to need one.