COB involving American Specialty Health
Primary insurance is contracted with American Specialty Health (ASH) to process specialized services like PT. Primary insurance pays on the PT claim but provider does not receive the full amount paid by primary due to involvement of ASH.
For COB purposes, should the amount paid by primary or the net received by provider be reported to secondary for the “other carriers paid” amount? The difference in those 2 numbers is affecting patient responsibility.
I don’t trust the secondary EOB because provider never sent secondary the primary EOB that shows what primary actually paid. I have sent secondary the primary EOB
Essentially the money that ASH intercepted is being passed to patient responsibility. Despite many hours on the phone with primary, secondary, and billing, I think it’s time for that magical conference call