Standard secondary coordination of benefits calculates based on what's left after the primary pays. If the fee is $100 and primary pays 50%, they pay $50. If secondary pays 50%, they pay 50% of what's left...so they pay $25. There is more than one way to calculate coordination of benefits, but the one I described is the most common. Is it possible to make it do that?
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We've resorted to not even listing the secondary anymore on the treatment plan because it's too confusing for the patient who still to this day thinks that they're going to get a double payment from their insurance companies (I think this has always been a low & dirty thing that insurance companies started doing, and it walks a fine line with the illegal activity of collusion. No other business in this country is allowed to do this...so why them? Why do they get to see what another business pays before paying what they truly owe the patient. If the subscriber is paying Cigna to cover 80% on a procedure and also paying Metlife to pay 80% on the same procedure, they both should be paying 80% or reimbursing the patient something as a "secondary"). It's all a bunch of bull. Anyway, it would be nice if this was updated. Thanks!
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