Create and Submit a Secondary/Tertiary Claim

Some patients have coverage with multiple payers at once. Having additional coverage helps reduce the patient's overall out-of-pocket expense, including any patient responsibility remaining after the primary payer's payment.

Workflow

Secondary and tertiary claims are created using the same process in the RCM. Once the primary (or secondary) payer has made the final payment, a secondary (or tertiary) claim can be created. Let's review the process together! 

• 1. Navigate to the Patients section of the RCM.
     
  2. Find the patient's name and click the Claims quick link.
      
  3. Next, locate the claim and click the State dropdown.
      
  4. Select Close and Submit to Secondary.
      
  5. Confirm both the Current Claim Internal Control Number and Final Primary Insurance Payment dropdowns are correct before clicking Close And Go To Submit Claims.
     
  6. Finally, follow the claim submission workflow to complete the process.
• 1. Navigate to the Patients section of the RCM.
     
  2. Find the patient's name and click the Claims quick link.
      
  3. Next, locate the claim and click Close and Submit Tertiary.
     
  4. Confirm both the Current Claim Internal Control Number and both final insurance payment dropdowns are correct before clicking Close And Go To Submit Claims.
     
  5. Finally, follow the claim submission workflow to complete the process.

  Note: If the secondary claim needs to be closed and a tertiary claim does not need to be submitted, create the tertiary claim and use the mark as submitted feature. Once complete, the tertiary claim can then be closed.