Filing a secondary insurance claim
This article covers how you can create and file secondary insurance claims within Healthie. There are many reasons that a client may have secondary insurance - ranging from different types of services covered by each plan, to a client purchasing supplemental insurance, to having coverage via multiple plans, such as through a spouse.
In this instance, you'll want to make sure to file claims with primary and/or secondary insurances appropriately.
Add a Client's Secondary Insurance
Within Healthie's client information, you can add multiple insurance policies. To add a client's secondary insurance, navigate to the client's profile and click on the "Actions" tab. Expand the "Insurance" menu.
From here, you can view any existing insurance policies on file for the client. Click "Add Policy" to add a secondary insurance policy to your client's profile.
Under the "Type" drop down menu, be sure to indicate that this insurance policy is a Secondary policy. Click the blue "Save" button to ensure that all changes are saved in the client's profile.
Create a Secondary Insurance Claim
Similar to how you create a primary insurance claim, you can create a secondary insurance claim. You can follow the same steps to create the CMS-1500, except you will select the client's secondary insurance rather than the first. Use the drop down menu to select the existing secondary plan to bill. We recommend putting the primary claim # under the Original Reference Number.
You'll find more information on completing the insurance details of an insurance claim, along with corresponding boxes on a CMS claim here.
However, please note, for many insurers, it may be required to attach the original claim EOB in order for the secondary to be processed. If this is the case, unfortunately, the EOB cannot be attached within Healthie at this time. You may want to consider exporting the claim as a TXT file, and uploading it to the secondary insurer's payer portal, and following steps to attach the EOB according to the payer portal instructions.
Alternatively, the claim can be created outside of Healthie, directly within the secondary insurer's payer portal, or through Office Ally directly (see more details below).
Secondary Claims Through Office Ally
If you use Office Ally, you may want to create your secondary claim directly within Office Ally, as there is a separate indicator/box that will flag the claim as a secondary. You'll also be able to attach the EOB from the original claim, which may be necessary for claim processing by the secondary insurer.
You'll find step-by-step instructions from Office Ally below:
If a claim is submitted outside of Healthie, the claim will not show on your claims list for tracking the status/details. In this case, we recommend that you use both the Insurance Notes of the client's profile, and the Reimbursement Notes within the original claim's details for your workflows.
Client Profile - Insurance Notes
CMS 1500 Claim (to Primary) - Reimbursement Notes & Details
From your CMS 1500 list, select your original claim > Reimbursement Details
Here you'll be able to edit the reimbursement details, and make internal team notes.
If you'd like to collect a remaining balance amount from a client, we suggest that you send them an invoice.
Optionally, you can choose to Remove Client Responsibility from the original claim, if payment was received from the secondary insurer and/or client.