Billing secondary insurance
None

Looking for the accurate and most efficient way to bill a Medicare secondary in SP.

18 comments

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    Sher Van Fossan, MSW, LISW-CP

    I'm looking for the same thing.  

     

     

    I'm looking for the same thing.  

     

     

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    Katrina Crader

    We need the same thing.  We have hundreds of clients who are Medicare / Medicaid.  We have no idea how to find the secondary claims that have not been sent to the clearinghouse.  Does it appear on a report anywhere at all?  Or even on a data extract?

    We need the same thing.  We have hundreds of clients who are Medicare / Medicaid.  We have no idea how to find the secondary claims that have not been sent to the clearinghouse.  Does it appear on a report anywhere at all?  Or even on a data extract?

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    Cate

    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.

     

    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.

     
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    Katrina Crader

    Hi Cate,

     

    How do I find the outstanding secondary claims that have not been filed?

     

    Thanks,

    KC.

    Hi Cate,

     

    How do I find the outstanding secondary claims that have not been filed?

     

    Thanks,

    KC.

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    Katrina Crader

    ?

    ?

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    Cate

    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: 

    https://support.simplepractice.com/hc/en-us/articles/207622996-Creating-claims-for-secondary-insurance 

    Thank 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: 

    https://support.simplepractice.com/hc/en-us/articles/207622996-Creating-claims-for-secondary-insurance 

    Thank you!

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    Katrina Crader

    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.

    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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    Cate

    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.

     

    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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    Katrina Crader

    Hi Cate,

    Thanks for the answer. I appreciate you guys addressing this in the future. I know we have thousands and thousands in secondary claims. Just not sure how to find it all. If you think of any workaround, please keep me in mind.

    Warmly,
    Katrina.

    Hi Cate,

    Thanks for the answer. I appreciate you guys addressing this in the future. I know we have thousands and thousands in secondary claims. Just not sure how to find it all. If you think of any workaround, please keep me in mind.

    Warmly,
    Katrina.

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    Kim A. Nelson

    We are in the same boat. And it's getting more and more complicated to track these as there is a "timely filing" requirement. I'd love to see this function very soon. 

    We are in the same boat. And it's getting more and more complicated to track these as there is a "timely filing" requirement. I'd love to see this function very soon. 

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    Michelle Gardiner

    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

    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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    Michelle Gardiner

    I thought I'd seen somewhere in SP that indicated that a claim was even sent to a secondary, but now can't find it.  Any suggestions?

    I thought I'd seen somewhere in SP that indicated that a claim was even sent to a secondary, but now can't find it.  Any suggestions?

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    Tammie Demers

    Tricare West and Medicare will not longer take paper claims even for secondary. When I try to send them via SP  they get rejected  HELP.

    Tricare West and Medicare will not longer take paper claims even for secondary. When I try to send them via SP  they get rejected  HELP.

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    Yolanda Winfield

    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. 

    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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    Tiffany Bronk

    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. 

    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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    Ashley Donovan

    Have there been any progress re billing Medicare as a secondary insurance? I keep getting rejection errors, despite following directions to submit.

    Have there been any progress re billing Medicare as a secondary insurance? I keep getting rejection errors, despite following directions to submit.

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    Ashley Donovan

    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!

    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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    Yolanda Winfield

    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.

    Edited by Yolanda Winfield

    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.