Practice Quiz

Medical Coding

Category - Compliance and Regulatory

Start a Study Session Sign up for Question of the Day
Sheila took her 5-year-old daughter to the pediatrician’s office for an annual well-child exam. She has a commercial Blue-Cross Blue-Shield insurance plan, through her work, which covers her daughter. Sheila also has Medicaid coverage on her daughter, due to her low-income status. Which one of her insurances is billed for the well-child exam?
  1. You bill Blue-Cross Blue-Shield first and Medicaid second
  2. You bill Medicaid only
  3. You bill Blue-Cross Blue-Shield only
  4. You bill Medicaid first and Blue-Cross Blue-Shield second
Explanation
Answer: A - You bill Blue-Cross Blue-Shield first as the primary payer, and send a secondary claim to Medicaid, once the primary insurance has paid. Medicaid is always the payer of last resort, and as such is always billed after a commercial insurance processes the claim.
Was this helpful? Upvote!
Login to contribute your own answer or details
Start a Study Session Sign up for Question of the Day

Top questions

Related questions

Most popular on PracticeQuiz