Submitting Secondary Claims

Can we submit secondary claims electronically?

Today world is everything is electronic, world moves towards no more paper but the difficult one is submitting secondary claims. Still we submit the claims by paper but it seems to be changing.

Each state has different carriers that allow secondary claims electronically but the big ones like Medicare, Medicaid, United Healthcare and Blue Cross Blue Shield are accepting them. Call your local insurance carriers to identify if they accept it.

And everyone's biggest question is how does the primary EOB get attached to the Secondary claim. Well, it doesn't get attached - paper claims are so different from electronic claims. The electronic claims can transmit so much more information but in lamens terms the claim goes out with the following:

Box 28: Total Charge
Box 29: Amount Paid (this would reflect what the primary insurance paid)
Box 30: Balance Due

This means it's the biller's responsibility to post the primary insurance payment correctly or else you can run into other issues like refunds for overpayments from the secondary etc.

No comments:

Medical Billing Popular Articles