Create a Secondary Claim

  • Updated

When billing claims after the primary payer has remitted on the primary claim, you may need to send the claim to a secondary payer. This article will detail how to submit a claim to the secondary.

Adding a Secondary Payer

To submit a claim to a secondary payer, you’ll first want to make sure that the secondary payer has been added to the patient’s insurance set. 

  1. Open the Patient Profile > Treatment Episode > Intake > Insurance
  2. If the Secondary column of the set states [Create], the patient does not have a secondary payer associated with their Insurance Set. 
  3. Click the [Create] button and select an existing payer from the drop-down or click Add New Payer if the payer has not yet been added to the practice.
  4. Click Select. 
  5. Complete the Policy Holder information tab, at a minimum including the Insurance ID and Patient Relationship to Insured.

Note: If the claims were submitted without the secondary payer attached and it should have been - corrections will be necessary. Please see this video for assistance with Claim Corrections. 

Close and Submit to Secondary  

Once you’ve confirmed that the patient has a secondary payer associated with the claim, you can then begin creating the Secondary Claims.

  1. To create the secondary, open the Patient Profile > Treatment Episode > Insurance Billing > Claims tab.
  2. This tab shows all of the patient’s claims and is where secondary claims are created.
  3. Any secondary claims that are ready to be created will display Close and Submit to Secondary link.

  4. Click on Close and Submit to Secondary.
  5. The Current Claim Internal Control Number (ICN) field may auto-populate, but if it doesn’t you may need to enter the ICN from the primary claim.
  6. Next, select the Final Primary Insurance Payment (if not automatically selected).
  7. Once that information has been entered, you can then select Close if there are more secondary claims to close or Close and Go to Submit Claims if you are ready to submit.
  8. Next, navigate to the Submit Claims tab (Work Center > Insurance Claims) and submit the claims.

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