In order to ensure secondary claims generate properly, at least 2 forms of insurance must be on file for that client. The insurance Payer Order must be set for both insurers, with one identified as ‘Primary’ and the other as ‘Secondary’.

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Add all the required Insurance information:

• Insurance Company
• Insurance Member ID
• Insurance Group Number
• Insurance Plan Name
• Relationship to Insured

Note: Follow this guide if the relationship to insurance is different from the self option.

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Once the attendance is marked on a service event, two claims are going to be generated:

The Primary Insurance Claim will be generated in ‘Pending’ status.

The Secondary Insurance Claim will be generated in ‘Pending Primary’ status under the Secondary Claim log.

When you submit your primary insurance claim it will be updated to the ‘Submitted’ status.

Once the ERA for the primary claim comes back into the platform, the secondary insurance claim status will be updated to ‘Ready to submit’.

Note: Inside of the secondary claim you are going to see the primary insurance claim, the primary payer adjustment information automatically filled in for you. This is going to fill in the code and the amount, the adjustment reasons, the remit date and payment. This information is pulling in from your primary ERA.

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Once your secondary claim is ready to submit, (meaning that your primary has come back) it's ready to be submitted. You would follow the same steps that you take in a primary submission:

• Open the claim.
• View the information.
• Submit the secondary claim.

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Wait for an ERA for the secondary claim to come back in and you'll see your status change according to the ERA:

• Paid: would mean that your ERA recorded a payment.

• Not Paid: would indicate that your ERA did not record a payment or the claim was rejected.

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