The first health plan to pay when more than one plan is active is referred to as what?

Study for the Physician Office Billing Test with our comprehensive flashcards and multiple choice questions. Each question includes hints and detailed explanations to ensure you're fully prepared. Master the billing process in physician offices and ace your exam!

The health plan that pays first when more than one plan is active is referred to as primary insurance. This term is essential in understanding how health insurance claims are processed when multiple insurers are involved. The primary insurance is responsible for covering the initial expenses according to the terms of its policy, which means it will pay first before any other insurance plans step in to assist.

This hierarchy ensures that there is a clear order in which claims are handled, preventing confusion over which policy should cover specific costs. The coordination of benefits rule directs how payments are managed, with the primary insurer typically covering a larger portion of the bill, while other policies, such as secondary or tertiary insurance, may cover remaining costs or specific gaps based on their agreements and coverage limits.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy