How to Bill Secondary Insurance and Submit Secondary Claims

Summary: Secondary claims will submit only when a valid active secondary insurance is configured and a secondary claim exists; many claims cross over automatically (Medicare often does), and you can also bulk-submit ready secondary claims or create a secondary claim and post the remaining payment manually.

What is required before billing a secondary insurance?

Before billing a secondary insurance, two conditions must be met:

1. Active secondary insurance: A secondary insurance entry must exist on the patient’s chart and be set to active.
2. Correct COB order: The coordination-of-benefits (COB) order must be configured so the secondary payer is listed after the primary.

If a secondary insurance is missing or inactive, the system will not create or display a secondary claim.

How can secondary claims be created and submitted?

1. Add the secondary insurance to the patient chart and ensure it is active and in the correct COB order.
2. Create the secondary claim (a "Create Secondary Claim" option appears in the claim side panel once a valid secondary is present).
3. Submit the secondary claim:
   • Many claims cross over automatically to the secondary payer (Medicare commonly does this).
   • You can manually submit secondary claims individually.
   • You can bulk-select and submit secondary claims from the Charges > Claims page; any claims marked Ready will be included in an outgoing batch at midnight.

How do you post secondary payments against a secondary claim?

1. Ensure the secondary claim exists (see steps above).
2. From the EOB/remittance, post the remaining patient responsibility amount against the secondary claim.
3. If the secondary check number is the same as the primary check number, create a unique identifier by appending a character to the original check number (for example, add an "S" at the end), then post the secondary payment using that modified number.

How can bulk actions help with secondary billing?

• Use bulk actions on the Charges > Claims page to change status and submit multiple claims.
• Claims in Ready status will be batched and sent overnight (midnight batch).

What should you do when primary payer information was incorrect and claims need resubmission?

• Correct the payer information on the claim or patient chart.
• Use bulk actions on the Charges > Claims page to resubmit multiple corrected claims at once instead of resubmitting them one at a time.

Are there special considerations for dual plans sharing a policy ID?

When a member has a dual plan that shares the same policy ID — for example, a Medicare plan paired with a Medicaid dual plan — you must add the secondary payer as a separate, distinctly named insurance entry (for example, a Medicaid payer record). This allows the system to distinguish primary from secondary and generate the correct secondary claim.

Note: If you do not add the secondary payer as a distinct entry, the system may be unable to create the secondary claim.

Troubleshooting: common issues and solutions

• Secondary claims not available after posting primary payment:
  • Verify a secondary insurance is added, active, and ordered correctly for COB.
  • If secondary is inactive or missing, add/activate the secondary insurance and then create the secondary claim.
• Unable to bulk-submit secondaries:
  • Ensure claims are marked Ready; Ready claims are included in the midnight batch.
  • Use the Charges > Claims page bulk actions to select and submit multiple claims.
• No place to post secondary payment:
  • Confirm a secondary claim exists; create it if needed, then post the remaining amount from the EOB to that secondary claim.
• Duplicate check number conflicts when posting secondary payments:
  • Use a modified duplicate check identifier (for example, append a character to the original check number) to post the secondary payment separately.

Summary: To successfully bill a secondary insurance:

1. Add the secondary payer to the patient chart and confirm it is active with the correct COB order.
2. Create the secondary claim using the Create Secondary Claim option in the claim side panel.
3. Submit the claim by allowing automatic crossover (when supported), bulk-submitting Ready claims (batched nightly at midnight), or submitting individually.
4. Post secondary payments to the secondary claim from the EOB or remittance advice; use a modified check number if the secondary check number conflicts with the primary.