Filing Secondary and Tertiary guarnatee Claims

When we first started our medical billing firm in 1994 I had no former contact at billing any medical claims, let alone secondary and tertiary. (You mean some people have 3 insurances?) I knew nothing. In fourteen years of billing I've learned quite a bit and I see from questions in our forum that many beginners do not understand secondary and tertiary claims billing at all.

First of all, how does anything get two or three policies and which is carefully primary? If a husband and a wife both work (who doesn't?) and they are both covered by health assurance by their employers, they may both have house policies so they are both covered under each others plan. One would be customary and the other secondary. Now if one of this couple (a few years ago we would have assumed that it would only be the husband) had former military contact and carried over their Tricare military insurance, that would be the third payor (if there was a balance left).

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Which firm is customary and which one is secondary is carefully by one of a couple distinct methods. First of all, if a person is working and they carry insurance, that assurance is customary (unless they have Medicare and their owner has less than 100 employees). If a person is retired and has Medicare but the spouse works and carries a house policy, then the spouse's plan would be customary and the Medicare would be secondary.

Filing Secondary and Tertiary guarnatee Claims

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There is no way to cover every scenario but basically either or not the person or the spouse is working can conclude the order. For dependents (usually children) some go by the "birthday rule" meaning that whichever parents birthday falls first in the year is primary. Of course with all of the disunion out there sometimes the order of assurance is carefully by a court order.

When a outpatient is seen by a victualer the claim is sent on a Cms 1500 form to the customary assurance carrier either electronically or on paper. Electronically it can be sent either directly to the assurance carrier by extra software or through a aid or through a clearing house. When sent on paper it simple means the claim is printed to a paper Cms 1500 form and sent through the mail. anything the case is, it is foremost that you know the order of the policies.

Once the customary assurance carrier pays their share of the claim it is then submitted to the secondary assurance firm if the outpatient has one. Secondary claims can also be sent electronically and on paper. Medicare is mandating electronic submissions even on secondary claims. When submitted electronically all the facts from the eob (explanation of benefits) is entered into the claim facts and submitted to the secondary assurance carrier.

When the secondary is submitted on paper, the claim is printed out again on a cms form and a photocopy of the eob is attached. If other patients are listed on the eob, their personal facts should be hidden. Many offices use black markers (we call them smelly pens) to draw through the unwanted information. I've set up a bunch of assorted width strips of white cardboard that we slide into clear article covers to cover the unwanted facts before we photocopy. We only do this with clubs that are not yet accepting electronic submissions.

If there is still a balance after the secondary assurance carrier pays their share, the claim is sent on to the third carrier. It is printed out again on a cms form and copies of the eobs of both the customary and the secondary assurance carriers are attached.

Whenever you send secondary and tertiary claims on paper, make sure the photocopies you attach are clear, easy to read, and for the accurate date of service. Many assurance carriers scan the eobs which lightens them a little. If the copy you submitted was already light, by the time the claim is processed it may be sent back to you as unreadable. It takes a lot more time to find the customary eob and resubmit a claim than it does to get it right the first time.

Secondary and tertiary claims can sometimes seem like a pain to get paid - especially because they can be for a very small whole of money. It is still foremost to file and track these claims to keep your receivables under control. It may not seem like a lot of money but it adds up. If you have a principles for submitting them it easily isn't that bad.

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