Secondary Claims Overview
A single date of service can have both a primary claim and a secondary claim. Each claim has its own balance and set of financial transactions to track payments, adjustments, and patient responsibility.
Automated Secondary Claims
PatientStudio simplifies claim management by automatically creating a secondary claim when posting the primary claim, provided all of the following criteria are met:
The patient has a secondary insurance on file.
There is no remaining insurance balance on the primary claim.
The patient responsibility amount from the primary claim is greater than $0.
This automation ensures that secondary claims are created only when needed, reducing manual work and improving efficiency in the billing process.
Medicare Supplement Claims
Medicare Supplement Claims
1. From the ERA screen: If a secondary insurance is present in the patient's profile, "Forward to Secondary" will appear on the posting modal.
2. Click "Post EOB"
3. Click "Post"
4. Click the DOS to view the claim
5. Notice the primary claim is closed. Click "Secondary Claim"
6. The secondary claim was automatically created based on the patient responsibility from the primary ERA
7. Because Medicare forwards remittance to the supplement plan, the secondary claim automatically moves to "Accepted by Payer"
Commercial Secondary Claims
Commercial Secondary Claims
1. From the ERA screen: If a secondary insurance is present in the patient's profile, "Forward to Secondary" will appear on the posting modal.
2. Click "Post EOB"
3. Click "Post"
4. Click the DOS to view the claim
5. The primary claim was closed. Click "Secondary Claim"
6. The secondary claim was automatically created and set to "Ready To Bill"
7. To submit this claim, click "Claim Actions"
8. Click "Submit claim"
9. Click "Submit"
10. Click "Close"
