Secondary Claims

Payer Library – Step 1

Confirm the following:

•    Payer ID #’s: Both Primary and Secondary Payer’s MUST have the correct ‘Payer ID’ numbers.

•    If the Secondary payer is Medicare, confirm that Medicare secondary ‘Ins.Type Code’ is selected. 

 

Patient Information Screen – Step 2

Confirm the following:

•    Secondary Insured’s Name, DOB and Gender are entered.

•    Secondary and Primary Insurance with Payer ID and Claim Filling Indicator is selected.

•    Secondary Insured’s ID# is entered in the ‘Insured’s ID’ field.

•    If Medicare or Medicaid claims, Group field must be blank.

•    For Medicare Secondary, Plan or Program Name must be blank.

•    Secondary subscriber ‘Relationship Code’ is selected.

•    SSN and Patient Member ID number must be blank. See ‘Other Patient Information’.

Claim Screen – Step 3

If your payments were not previously auto-posted using the Auto-Posting feature, manually enter payment information from your Primary EOB. Go to Home > Enter Payment screen.

Confirm the following:

Payment Entry Screen

•    Line Item payments and/or adjustments with a date have been entered on the Payments screen.

•    Every service line has an Insurance payment entered; even a $0.00 amount must be entered as a payment.

Claim Information Screen

•    ‘Bill To’ has been set to ‘Secondary Insurance’.

•    ‘Ready to Submit’ is selected under ‘Claim Information’.