Billing a Secondary Insurance

If a claim has a remaining balance after the primary insurance has paid, you will want to submit the claim to the secondary insurance, if one applies. This article assumes that the primary insurance did not cross over the claim to the secondary insurance on your behalf.

Bill a Secondary as Print & Mail

If the secondary insurance is Print & Mail or they do not accept electronic secondary claims, you have 3 options of posting the primary payment:

• Batch Insurance
• ERA
• Single Session - Insurance w/ Adjudication

There is no need to use COB Batch Ins as you are required to attach a copy of the EOB for paper claims. To create a Print & Mail secondary claim:

1. Post the primary payment using your preferred payment screen. Select Resubmit or Send to Insurance Invoice Area as the action.
2. Navigate to Billing > Bill Insurance and select the client.
3. Select all desired service lines and Create Invoice.
4. On the secondary insurance card, select the  icon. To learn more about creating a paper claim, please see: How to Create a Paper Claim
5. Once the claim is created, print the CMS-1500 using your desired format.
6. Attach the EOB before mailing the claim.

Note: If Medicare is secondary, Box 29 will show 0.00 as the Paid Amount. This is per Medicare CMS-1500 requirements.

Bill a Secondary Electronically

For payers that accept electronic secondary claims, you have 3 options of posting the primary payment:

• COB Batch Insurance
• ERA
• Single Session - Insurance w/ Adjudication Info

To create an electronic secondary claim:

1. Post the primary payment using your preferred payment method. Select Resubmit or Send to Insurance Invoice Area as the action.
2. Navigate to Billing > Bill Insurance and select the client.
3. Select all desired service lines and Create Invoice.
4. On the secondary insurance card, select the  icon. To learn more about creating an electronic claim, please see: How to Create an Electronic Claim

When you create a secondary claim electronically, the primary adjudication information is embedded into the EDI file. This removes the need to send a copy of the EOB to the secondary insurance.

Note: If Medicare is secondary and you choose to look at the CMS-1500, Box 29 will show 0.00 as the Paid Amount. This is per Medicare CMS-1500 requirements. However, the Paid Amount will be embedded into the EDI file as with other electronic secondary claims.