When handling a patient’s insurance with Blue Cross Blue Shield (BCBS) as primary and Medicare as secondary, how should you submit the coverage?

Identifying Blue Cross Blue Shield (BCBS) as the primary insurer and submitting a coordination of benefits to Medicare if necessary is the correct approach when handling a patient’s insurance coverage with BCBS as primary and Medicare as secondary.

This is crucial because when there are two insurance plans, the primary insurance is responsible for paying claims first, and only after that does the secondary insurance come into play. By submitting to BCBS first, you ensure that the claim is processed according to their guidelines, which may involve determining the payment amount. After BCBS processes the claim, you can then submit the remaining balance to Medicare for any additional coverage, utilizing the coordination of benefits process if needed. This method helps prevent delayed payments or claim denials, ensuring that the patient’s insurance benefits are maximized efficiently.

The other options do not follow the proper protocol for insurance processing. Submitting as BCBS as secondary would lead to incorrect billing practices, while simultaneous submission without specification could create confusion in the claims process. Lastly, submitting only to Medicare ignores the primary coverage that BCBS provides, which can lead to payment issues and the patient potentially facing unexpected costs.