How to e-bill Secondary Plans?
Claims > Claims Management > Processed > Crossover > Secondary and Tertiary
On the Payer List, those listed as ‘Payer Accepts COB (electronic Co-ordination Of Benefits)’ or ‘Electronic COB’ can be billed electronically.
NOTE:
For Capario, user can choose: web lookup, PDF, or excel versions by clicking here. The web lookup for Gateway EDI can be accessed by clicking here.
1. If not already done, set the plan in CureMD to bill electronically. Configure the desired plan. For example, let’s setup CIGNA PPO.
NOTE:
For setting up the billing configurations click here.
Firstly, from the payer list look for the Cigna PPO and ID for Professional claims.
The Payer ID is 62308, the EDI version is 5010, and the Payer accepts COB.
Set the following fields:
- Claim Gateway
- Electronic
- Accept COB Claims
Now check if the Payer provides eligibility:
The payer ID is same, so fill in the Eligibility Gateway with the same Payer Number and click on the ‘Save’ button.
NOTE:
If a plan allows electronic claims when it is primary, but cannot handle electronic COBs, user needs to setup separate plans for primary and supplemental insurances.
For example, if ABC Insurance can receive electronic claims, but can’t handle COBs, and one of user’s patients has ABC Insurance as their secondary, add plans:
- ABC Insurance (set to bill electronically)
- ABC Insurance Supplemental (to bill on paper)
2. When the primary insurance payment is posted, and the secondary can be billed electronically, the secondary claim will automatically show under:
Claims > Claims Management > Newly Created > Clean (or Incomplete)
and can be billed from there. For step by step instructions, please click here.
