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Secondary claims

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22 comments

  • Avery

    Hi Shana,

    Currently, the best way to ensure that secondary claims are filed, accepted, and paid by an insurance company will be to file them on paper outside of SimplePractice. When doing this, you'll want to attach the primary payer's EOB to the secondary claim and then mail both documents in to the secondary insurance payer.

    To help in this situation, you'll be able to create secondary claims within SimplePractice and then print them out so they can be mailed. This will keep you from having to manually enter the client's (and your) information on the claim form. For more information about how to do this, I have linked to a couple of helpful guides from our Help Center:

    Creating claims for secondary insurance

    Creating and printing a CMS 1500 (HCFA) claim form

    All the best,

    -2
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  • Renee Hunter

    What if the insurance doesn't take paper claims... Seems like SP should be able to allow us to attach the eob to the claim. 

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  • Brenda Webster

    This has been a huge thorn in our side as well.  It takes so many administrative hours to bill out to secondary insurance!  We have to hunt down the primary eob, create the secondary claim and then submit both to the secondary via email/fax/snail-mail (depending on the insurance company's preference).  

    I would kiss someone on the face over there if SP could get secondary insurance billing handled in-house!!! (It might also get me to steer away from looking at other options out there...)

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  • Sujeong Shin

    I'm new to SimplePractice. I have completed my claim for my client's primary insurance company. Do I have to wait to receive an EOB before submitting my secondary claim? Please advise. 

     

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  • Gillian

    Hi Sujeong, I'd be happy to help. Typically, you'll need to wait until the primary claim is submitted and paid to receive the EOB. Because most insurance payers require that the EOB from the primary claim is attached to the secondary claim, you'll need to wait to receive an EOB before submitting the secondary claim.

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  • David Stahl

    Any news about electronically submitting secondary claims?  If there is no movement on this can we atleast figure out a way I can attach a primary EOB myself and attach to the SP claims electronically to try that process?  The whole process is manual but sending them electronically with some work on the provider side would be a good compromise for the time being.  Thoughts?

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  • Gillian

    Hi David, we're continuing to work with our clearinghouse and engineering team to make secondary claim submission in SimplePractice better. Currently, the best way to submit a secondary claim when you need the primary EOB attached is to create the secondary claim in SimplePractice, then download it to either print and submit with a paper copy of the EOB, or print as a PDF to include with a PDF version of the EOB. 

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  • David Stahl

    That is how we are doing our current process.

    Do you have a possible launch date to do electronic?  This has been a very large time consuming piece to our workflow.  Just want to know there is an eventual end in sight.  Thanks.

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  • Gillian

    Hi David, we are making great progress, but do not have a specific release date to share at this time. 

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  • Permanently deleted user

    We just got notice from a patient that their secondary has changed as of January 1.  I have tried to edit the secondary claim that was submitted by paper, but every time I save the changes made it reverts back to the previous information.  What am I doing wrong?

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  • Gillian

    Hi Karla, because this is specific to your account and the claim, our Success team will reach out to you privately to assist.

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  • Ryan C. Randall

    Any news as to when secondary claims software will be up and running?

    This is becoming VERY frustrating and leading to income loss.

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  • Gillian

    Hi Ryan, we are actively working on it. You can vote for this feature and subscribe to updates here: https://simplepractice.uservoice.com/forums/918553/suggestions/39135703

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  • Marcia Kennedy

    More frequently I am having difficulty getting secondary claims paid because the primary EOB is not attached so the insurance company cannot see it. This is resulting in me having to print and send claims. I am a one person office and was hopeful that this EHR would be able to provide this basic function. I am using much valuable time doing these by hand. Will this be resolved within the next 30 days or do I need to look for an EHR that has this streamlined?

     

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  • Gillian

    Hi Marcia, because of the complexity of this project, it is not likely that we will be able to complete this within the next 30 days. We're here to support you, and are happy to help with any questions.

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  • Sarah McGiven

    Hello,

    I am wondering if someone can tell me how to access the ERA's on Simple Practice. Since some insurances are not sending EOBs when they are automatically posted into Simple Practice, I need to access those in order to send them with a secondary claim. Any help would be much appreciated.

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  • Gillian

    Hi Sarah, I'd be happy to help. You can find your ERAs under Reports > Payment Reports.

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  • Terek Kanso

    Hello,

    Another issue I've run across with secondary claims is that some insurance companies require that they be printed on an original claim form, and the one we can print in SP is not the original.  Is there a way to print the information without the form loaded, so that we can use our claim forms?  I've just had dozens of Kaiser claims sent back to me because they don't accept the red CMS 1550 if the red is actually printed on the page.

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  • Marcia Kennedy

    Terek K, 

    I just had FIVE PAGES of rejected secondary claims sent to me from the past year because the red ink was not the right color of red. I received this nasty bit of news on April 17th. I made an appointment with a provider rep from the insurance company to teach me how to enter these into the company website and bypass the EHR. 

    This is extremely time consuming, leads to loss of income, and complicates my life rather than making things simpler. 

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  • Gillian

    Thanks for your feedback, everyone. Terek, you can choose to print Claim Fields Only when printing a claim form, and you can purchase claim forms at most major office supply stores or online. 

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  • Cheryl Smith

    I just switched to Simple Practice and did not realize that you do not automatically submit secondary claims. This is disappointing and takes a lot of time for me which I didn't have with my former clearing house, Office Ally. It sounds like you are trying to remedy this. How close are you? I am in my first trial month and would like to know soon. Thanks!

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  • Megan R. West

    Any updates on this? This has been an ongoing issue where the solution was making "great progress" two years ago... 

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