Do you have questions about using dual or secondary insurance coverage for services at Rula? This article will provide you with details about plan coverage and how-to submit coverage information.
Secondary Insurance (or Dual coverage)
We understand that many clients may have secondary insurance coverage to help cover additional healthcare costs. While we fully support the use of secondary insurance, we want to inform you that secondary coverage information cannot currently be loaded into our online portal. However, we have alternative processes in place to ensure your secondary insurance coverage is accurately accounted for.
How to Submit Secondary Coverage Information
If you have secondary insurance coverage and wish to ensure it is properly accounted for in our billing and insurance systems, please email the plan and subscriber information to support@rula.com.
Note: including a picture of the front and back of the card can expedite the process (and is preferred).
Multiple insurance coverages will be subject to coordination of benefits rules.
Dual Eligible Coverage
Dual Eligible plans cover patients who are eligible for both Medicare and Medicaid coverage through a commercial insurer.
Please note that Rula participates only in Medicare Advantage plans for certain insurance companies in certain states and Medicaid plans for Kaiser Permanente patients in Hawaii only. Rula does not participate in most Medicaid and Medicare Advantage plans, so dual-eligible plans are often out-of-network. You can review a full list of which Medicare and Medicaid plans are accepted at Rula in this article: Understanding if Rula accepts your insurance.
If you have dual coverage, please email the plan and subscriber information to support@rula.com so we can verify your benefits properly.
Note: including a picture of the front and back of the card can expedite the process (and is preferred).
Coordination of benefits (COB)
It's important for patients to keep accurate records, monitor claims, and follow up with insurers to ensure proper coordination of benefits (COB). By facilitating communication between insurance companies and healthcare providers, COB helps clients receive the full benefits they are entitled to while avoiding billing issues and unexpected costs.
The coordination of benefits (COB) rules determine the order in which insurance plans pay claims when a person is covered by more than one plan.
Here are some key COB rules:
- The plan that covers the person as an employee or primary policyholder is primary, while the plan that covers them as a dependent is secondary.
- For dependent children, the plan of the parent whose birthday comes earlier in the calendar year is primary. If the parents are divorced/separated, the plan of the parent with custody is primary.
- For active employees covered by their employer's plan and Medicare, the employer plan is primary if the employer has 20 or more employees.
- If a person is covered as an active employee and also has COBRA continuation coverage, the active employee plan is primary.
- If none of the above rules determine order, the plan that has covered the person longer is primary.
Additional Resources
- Understanding your insurance coverage - provides common insurance terms, and explains how to contact your insurance for accurate plan details
- What is an explanation of benefits (EOB)? - explains what is an EOB, typical information found within an EOB, claim processing steps and timelines, and how much you owe based on the EOB.