The contracts I helped my doctors get were very specific about COB. The clauses basically stated that we do not get involved with COB issues, that is a patient and insurance responsibility. Any COB denials were billed to the patient. If the claim was in review due to COB, they had 30 days to resolve it and pay the claim.

The one huge problem I have is when the secondary denies the claim saying the primary paid more. My contracts spell this out because I quote Florida law which says that the combination of the primary and secondary cannot exceed the providers charges. So, my contract demands the carrier pay the balances if the service is covered.

When we are not contracted and they do this, I simply bill the patient. The patient calls and screams they are paying through the nose for insurance and I simply tell the patient their secondary never pays a claim, so why are they putting good money into this insurance company. That's when I get the "You want your money, you deal with my insurance company." No problemo - send one statement with a final notice warning and off to collections they go. When they call back I tell them I am not contracted and from now on they can send their own claim and pay me 100%. I hate to be thay way but I am when they act the way they do.