SECONDARY CLAIM

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jsugal
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Joined: Wed May 31, 2017 10:19 am

SECONDARY CLAIM

Post by jsugal » Fri Mar 09, 2018 11:06 am

HI GAVIN,
IT'S CONSTANCE G. I HAVE A QUESTION. SOME OF OUR PRIMARY PAYERS DO NOT CROSSOVER CLAIMS TO SECONDARY INSURANCE COMPANIES. IN THE PAST, WE WOULD HAVE TO PRINT A PAPER CLAIM AND MAIL IT WITH THE PRIMARY REMIT TO SHOW WHAT THE PRIMARY INSURANCE PAID. WE WOULD LIKE TO SEND OUR SECONDARY CLAIMS ELECTRONICALLY INSTEAD VIA MAIL (MEDICARE-PALMETTO GBA WOULD PREFER IT). HOW DO I DO THIS? I UNDERSTAND HOW TO SUBMIT A SECONDARY CLAIM (CLAIM MANAGER, CHANGE THE STATUS FROM SENT TO READY TO SEND FOR THE SECONDARY INSURANCE, MAKE SURE IT HAS AN EDI #, REVENUE MANAGER, ETC). MY QUESTION IS THIS: HOW DOES THE SECONDARY INSURANCE (MEDICARE IN PARTICULAR- WHICH IS PROCESSED BY PALMETTO GBA) SEE WHAT THE PRIMARY HAS ALREADY PAID- SUCH AS THE CAS 2320 LOOP AND THE CAS 2430 FOR EXAMPLE? IS IT DONE FOR ME AUTOMATICALLY SINCE I ALREADY POSTED THE PRIMARY INSURANCE REMIT 835 AND THE PRIMARY INSURANCE IS "MARKED COMPLETE?" OBVIOUSLY WHAT I SEE ON A PAPER CLAIM IS MUCH DIFFERENT THAT WHAT PROBABLY GOES THROUGH AS AN ELECTRONIC CLAIM. I'VE DONE A BUNCH OF RESEARCH BUT IT STILL ISN'T CLEAR. I HAVE SEVERAL SECONDARY REMITS THAT I USUALLY HAVE TO MAIL (MEDICARE, TRICARE FOR LIFE ETC) AND I WOULD LOVE TO FIND A WAY TO MAKE IT EASIER, FASTER AND MORE EFFICIENT. THANK YOU SO MUCH FOR THE INFORMATION.

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Gavin Walker
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Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: SECONDARY CLAIM

Post by Gavin Walker » Mon Mar 12, 2018 9:15 am

Hi Constance, in Revenue Management when you go to Process Claims click the Select -> Pri & Sec -> Ready To Send. This will send both your primary and secondary claims all in the same batch. The default is only to send primary claims. If you and entered and posted the primary payer's EOB, then that information will go on the secondary payer's claim.
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

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