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  1. #1
    Join Date
    Jun 2012
    Posts
    1

    Default Primary Health Doesn't Cover, Secondary Becomes Primary

    My question involves insurance law for the state of: NY

    My primary insurance does not cover mental health at all. There is no reimbursement for any mental health costs. My secondary does cover it. Does my secondary become primary in this case. Should the doctor still submit to the Primary? The doctor is in-network for the secondary, will I get the discounted rate?

    Thanks for your help.

  2. #2
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,132

    Default Re: Primary Health Doesn't Cover, Secondary Becomes Primary

    Primary and secondary do not change by situation. You would still send the claim to the primary carrier first and get the denial; then the secondary carrier can pick up. The secondary carrier's responsibility is determined in part by what the primary carrier pays, so it is imporatnt to send them to the correct carrier in the correct order. If the doctor is in-network for the secondary carrier, then I don't see any reason why you wouldn't get the in-network rate.

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