Billing secondary insurance
Answered
Looking for the accurate and most efficient way to bill a Medicare secondary in SP.
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Hello all,
We are working to improve the functionality of our secondary claim processing, but in this case it will best to file secondary claims outside of SimplePractice so that you can include a copy of the EOB from the primary payer to prevent denials or rejections for invalid information. We do attempt to attach the ERA from the primary payer when submitting the secondary claim, however this sometimes does not transfer well to the secondary insurance company and results in the claim being denied or rejected.
You can use our system to create and download the secondary claims, and then I recommend submitting them to the payer with a copy of the authentic EOB from the primary plan (should have letterhead from the primary plan). Please refer to the following guide for the steps to download a claim:
Creating and printing a CMS 1500 Claim Form
We understand that having to file these claims manually is not ideal so please know that our team is working hard towards automating this process for you. -
Hi Katrina,
If you're enrolled in payment reports, once the primary claim has been claimed and if you have secondary insurance information entered for the client, the "create secondary claim" button will appear. Here is a resource that goes into more detail from our Help Center on this:
Thank you!
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Hi Cate,
Thanks for not answering the question. What I want to know is how to find the secondary claims. Primary claims show up in the insurance section. Outstanding secondary claims show up nowhere. How do I find them? Will a data extract help me? Is there a report that will help me? Will session billing status help me?
Katrina.
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Hi Katrina,
Right now, there isn't a report that allows you to view when you are required to create a secondary claim, so this is something you will have to manually track. However, we are working to improve the functionality of secondary claims in our product.
If interested in viewing some of current In Progress and recently released updates, here is the link to see our Product Roadmap: https://support.simplepractice.com/hc/en-us/articles/115005264123-SimplePractice-Product-Roadmap.
Thank you.
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I'm in the same boat and am finding it increasingly frustrating and time-consuming to manage and track the Medicare secondaries through SP. One of the reasons I chose SP over others is to simplify the business end of my sole-practitioner biz!
How close is SP to rectifying this situation??
Thanks,
Michelle
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The only way I have found to track secondary medicare claims or (any secondary claims for that matter) is by keeping a spreadsheet of the patient names who have secondary claims and checking them to see if they have been filed on a weekly basis. I know this is time consuming, but Medicare only gives you a year from the date of service to file, so we cannot wait for SP to fix this. I am so disappointed with the secondary claims filing in SP. We have to submit them all paper, and still have to make manual changes to the paper claim, because of missing or incorrect information to get it to process as a clean claim.
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Do we have any solution to this yet? We need unsent secondary claims to show up and be treated exactly as primary claims are. We also need lists to be able to track and check on them as they age. While we're on the topic we desperately need a way to enter a negative or a $0 pay claim. In some cases primary denies or the entire charge is a contractual write off but we need to be able to enter it before sending it to secondary.
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Can someone please advise on how to bill Medciare re secondary claims? I spoke with the Medicare EDI help desk who recommended that SP resolve the issue. She also suggested that I complete a new EDI enrollment and submit them through PC-ACE as a direct biller; however updating this information with NGS would replace the existing trading partner # (Simple Practice). I've been running around in circles and need support with addressing. Thank you!
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Ashley,
Here is what I have to do: I got the the Palmetto GBA website:
https://www.onlineproviderservices.com
Once you log in, go to the second tab "Claims", then "claims submission" You can enter all the primary and secondary claim information, and upload a copy of the primary insurance carrier's EOB and they will pay the claim. I know it is time consuming, but it works. I hope this helps.
If you are getting front end rejections from the Palmetto GBA website let me know I can help you with those also.
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