Billing Tertiary Claims

Version 14.19

In the rare case where a child has a tertiary insurance, you will find that the options for claim submission only includes transmitting claims to a primary payer or a secondary payer. In order to queue a claim to a tertiary insurance where there is a patient responsibility, you will need to manually change the insurance on the claim.

Note: It is recommended when sending claims to a tertiary insurance that the claim be sent on a CMS-1500 form rather than electronically.

While posting the secondary payment, do the following:

  1. In the Add Payments and Adjustments window, click the Insurance Action field dropdown and select the tertiary payer listed as XFR sec to send the balance to the tertiary payer.

  1. Save the secondary payment information.

In the Patient Account:

  1. Select the claim with the tertiary insurance balance.
  2. Click the CMS-1500 button  to print the claim. The claim will be printed with the tertiary insurance listed as the addressee and will show the cumulative primary and secondary payment amounts.
  3. Attach a copy of the primary and secondary EOBs and mail the claim.
Version 14.10

In the rare case where a child has a tertiary insurance, you will find that the options for claim submission only includes transmitting claims to a primary payer or a secondary payer. In order to queue a claim to a tertiary insurance where there is a patient responsibility, you will need to manually change the insurance on the claim.

Note: It is recommended when sending claims to a tertiary insurance that the claim be sent on a CMS-1500 form rather than electronically.

While posting the secondary payment, do the following:

  1. In the Add Payments and Adjustments window, click the Insurance Action field dropdown and select the tertiary payer listed as XFR sec to send the balance to the tertiary payer.

  1. Save the secondary payment information.

In the Patient Account:

  1. Select the claim with the tertiary insurance balance.
  2. Click the CMS-1500 button  to print the claim. The claim will be printed with the tertiary insurance listed as the addressee and will show the cumulative primary and secondary payment amounts.
  3. Attach a copy of the primary and secondary EOBs and mail the claim.