I have a situation where a dos was paid by GEHA insurance and it was processed on pt ledger. Turns out pt had another insurance as primary (Anthem) I was not able to open the dos and do a debit adjustment/insurance refund so that it reflected on the dos.
It also turns out the Primary (Anthem) paid the patient so I didn't get an eob/payment to be able to apply it on the dos.
When I print out the claim to what is now the secondary (GEHA) it reflects the original payment made by GEHA so the claim is not correct and does not reflect that a refund was made to GEHA.
When GEHA does pay as a secondary payer it will look like that dos has two payment from the same insurance. If someone does not go down the history a yr later they could miss the refund when looking at this dos.
Hope this makes sense