How to Generate Claim for Secondary?

There are multiple ways that a supplemental (secondary or tertiary) claim can be generated. Since secondaries are more common, we will concentrate on these. However, tertiary claims follow a similar pattern of rules. The options will be described below so user can choose the method appropriate to the payer:

Secondary Plans that User Can Bill Electronically

The secondaries that user can bill electronically depend on the clearing house user uses and the agreement user has with them.

A. Primary and Secondary Plans Can Both Go Electronically

On the Payer List, those listed as “Payer Accepts COB (electronic Coordination Of Benefits)” or” Electronic COB” can be billed electronically.

For Capario, user can choose: web lookup, PDF, or excel versions here.

For Gateway EDI, there is a web lookup here.

1. If not already done, set the plan in CureMD to bill electronically. In order to configure these settings click here.

2. When the primary insurance payment is posted, and the secondary can be billed electronically, the secondary claim will automatically show under:

B. Printing Paper Claims

1. Before printing, user should make sure to follow the instructions for configuring Crossovers and Medigap COBA IDs, in this guide, otherwise the print count will rise without serving any purpose.

2. When the primary insurance payment is posted, user can print the secondary as well. In order to do this click here.

3. Attach the primary EOB to the claim before mailing.

• If the primary was paid by ERA (Electronic Remittance Advice), user can easily print a copy of it. To learn how to do this click here.

C. Sending Secondary Paper Claims Electronically

Depending on the clearinghouse that user uses, and the agreement user has with them, user may be able to send claims to the clearinghouse to print. However, there may be additional charges for these services so user needs to check with CureMD Support for pricing before following these steps. Also, for printing secondary paper claims, the electronic file must include payment information from the primary plan.

To setup for use with Capario, click here.