Having Medicare or any other coverage of health insurance, this coverage type is known as Payer. In case there payer is more than one, then the coordination of benefits decides who pays first. First, the primary payer clears the amount it owes on the bills and the remaining is sent to pay or clear to the secondary payer (Medicare supplement plans). However, in some cases, there are third payers as well.
Who are primary/secondary payers?
- The first paying insurance is referred to as the primary payer and they pay or clear bills up to the coverage limits.
- The next following the first is the secondary payer who pays for the cost that were not cleared by the primary payer or the insurer.
- The secondary payer is the Medicare Supplement Plans 2018. They also do not pay for all the costs uncovered.
- In case the secondary payer is your employer insurance, you need to get enrolled in Part B Medicare, before insurance pays.
In case, the insurance company fails to pay promptly the claim, that is a period within 120 days, your other provider or your doctor may bill for the amount to Medicare. Under such circumstances, Medicare makes a conditional payment against the bill so that it recovers the payments later that the primary payer was expected to have cleared.
Conditional Payment, what’s it?
A conditional payment in Medicare supplement plans refers to a payment that Medicare pays for the services that it is not responsible for. This conditional payment is made by Medicare to keep you safe from spending to pay the bill. This is conditional as it needs to be repaid to Medicare in case there is a need for judgment, settlement, award or some later payment. Now, it is your responsibility to see that Medicare is repaid from other payments.
How does Medicare pull through conditional payments?
Medicare makes this payment as conditional and helps when there is a need. It is your lawyers or your duty to report for the judgment, settlement or to make any other arrangements so that Medicare receives its due payment. You can also contact the recovery center or acquire information on these payments. You can also consult with BCRC so that it calculates the amount of repayment and sends a letter requesting you make on this recovery case the repayment. As it is a conditional payment it becomes your responsibility to ensure Medicare receives the amount.