Wednesday, May 26, 2010

Secondary claim submission

General Insurance Information - Billing Your Secondary Insurance Company

Secondary Insurance Billing

Secondary billing is a necessary component to any healthcare organization; yet in order to receive every secondary dollar owed, many organizations are forced to invest valuable time and resources that can cost far more than the benefit of the secondary dollars themselves. Unless the secondary payer supports automatic crossover claims, secondary billing is still performed using a mostly manual, paper-based process. In almost every case processing secondary claims can be frustrating and time consuming, and devoting staff time to process claims that are often times in much smaller dollar amounts, can make the payoff seem not worth the effort required.

Billing your secondary insurance company can be a daunting task if you are not fully aware of the process. The information provided below is critical in helping you through this process so it doesn't feel so overwhelming. Understanding the terms used by insurance companies, determining if a policy is primary or secondary and the billing process will help to make this more manageable.

Insurance Company Terms

Insurance companies use terms such as primary, secondary, explanation of benefits (EOB) and claims. Primary insurance means this is the insurance policy that will be used first when you receive medical services. Sometimes the policy is primary because it’s your only policy and in a situation when you have two policies, the insurance companies make this determination. The explanation of benefits form can be used when there are two policies and you need to send a copy of this form (EOB) to your secondary provider. This form explains what the benefits are of that insurance plan. An insurance claim refers to the bill sent to the insurance company for the services you received.

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