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Primary insurance was actually secondary. How do I resubmit claim to primary?

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Stephanie Moniuk

We received a letter from Tufts stating that from April to September of this year client x had primary insurance under BCBS Massachusetts. Tufts is asking for the claims to be submitted to BCBS and either want the money paid back or they will take it off future payments. I'm not sure how to go about this - I don't want to delete the original claim, but billing BCBS as secondary seems incorrect since they are actually primary. In addition, when I generated a secondary claim just to see what it looks like it shows Tufts having paid the claim (which of course they did but are taking back).

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Comments

9 comments

Date Votes
  • Ruth

    Hi Eugene, I've created an email Help Request on your behalf so that a member of our Insurance Team can investigate your client's claim and insurance benefits for you. They should be able to get back to you soon with more specific recommendations on how to proceed! 

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  • Dr. Maria Gricelda Chacon

    i have the same issue, i send the original claim to Primera were the primary was actually HMA

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  • Venessa Folsom

    I am having this same issue.  How can I get SP to create a new claim now that the insurance information is updated so that the primary and secondary are correct and I can submit a claim to the primary insurance?  Thank you!

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  • Jay Norman

    I have the same problem.  Premera was billed as primary (per client instructions) Regence was secondary.  However, the payments were not adding up.  After an investigation, Regence said they were primary due to the birth date rule.  I called Premara, they did not have Regence listed. Now I have 27 mis-paid claims.  Is there a way to make the existing secondary claim a primary so it can be resubmitted? 

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  • Mary S. Dowling

    I have same issue. Primary insurance was actually secondary. How do I resubmit claim to primary? 

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  • Stacia L. Nilson

    Where's the answer? I'm having the same issue?

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  • Admin RK

    Is there anyway to get an answer posted for this issue or an article posted in SimplePractice Support? It seems that all of the Q&A questions posted about editing and resubmitting claims to a different insurance payer state a Help Request has been created as the answer. I am not able to find any articles posted in SimplePractice Support that show how to modify the insurance payer information when resubmitting a claim. I do not want to delete the initial claim submitted, along with any processing information about the claim, just to resend a corrected claim to a different insurance payer. 

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  • Michael Elder

    My problem is related but slightly different.  The client changed secondary insurance at the beginning of the year but I was not notified until April.  I need to submit secondary claims to the correct insurance.  How do I delete the ones sent in error so I can submit to the correct payer?  As with the post above, I doubt this is a unique problem so an article on how to do it would be helpful.

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  • Michael Elder

    My problem is related but slightly different.  The client changed secondary insurance at the beginning of the year but I was not notified until April.  I need to submit secondary claims to the correct insurance.  How do I delete the ones sent in error so I can submit to the correct payer?  As with the post above, I doubt this is a unique problem so an article on how to do it would be helpful.

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