Filing Secondary and Tertiary Insurance Claims

Filing Secondary and Tertiary Insurance Claims

When we first started our medical billing business in 1994 I had no previous experience at billing any medical claims, let alone secondary and tertiary. (You mean some people have 3 insurances?) I knew nothing. In fourteen years of billing I've learned quite a bit and I see from questions in our forum that many beginners do not understand secondary and tertiary claims billing at all.

First of all, how does anyone get two or three policies and which is determined primary? If a husband and a wife both work (who doesn't?) and they are both covered by health insurance by their employers, they may both have family policies so they are both covered under each others plan. One would be primary and the other secondary. Now if one of this couple (a few years ago we would have assumed that it would only be the husband) had previous military experience and carried over their Tricare military insurance, that would be the third payor (if there was a balance left).

Which company is primary and which one is secondary is determined by one of a couple different methods. First of all, if a person is working and they carry insurance, that insurance is primary (unless they have Medicare and their employer has less than 100 employees). If a person is retired and has Medicare but the spouse works and carries a family policy, then the spouse's plan would be primary and the Medicare would be secondary.

There is no way to cover every scenario but basically whether or not the person or the spouse is working can determine the order. For dependents (usually children) some go by the "birthday rule" meaning that whichever parents birthday falls first in the year is primary. Of course with all of the divorce out there sometimes the order of insurance is determined by a court order.

When a patient is seen by a provider the claim is sent on a CMS 1500 form to the primary insurance carrier either electronically or on paper. Electronically it can be sent either directly to the insurance carrier by special software or through a service or through a clearing house. When sent on paper it simple means the claim is printed to a paper CMS 1500 form and sent through the mail. Whatever the case is, it is important that you know the order of the policies.

Once the primary insurance carrier pays their share of the claim it is then submitted to the secondary insurance company if the patient has one. Secondary claims can also be sent electronically and on paper. Medicare is mandating electronic submissions even on secondary claims. When submitted electronically all the information from the eob (explanation of benefits) is entered into the claim information and submitted to the secondary insurance carrier.

When the secondary is submitted on paper, the claim is printed out again on a cms form and a photocopy of the eob is attached. If other patients are listed on the eob, their personal information should be hidden. Many offices use black markers (we call them smelly pens) to draw through the unwanted information. I've set up a bunch of various width strips of white cardboard that we slide into clear report covers to cover the unwanted information before we photocopy. We only do this with companies that are not yet accepting electronic submissions.

If there is still a balance after the secondary insurance carrier pays their share, the claim is sent on to the third carrier. It is printed out again on a cms form and copies of the eobs of both the primary and the secondary insurance carriers are attached.

Whenever you send secondary and tertiary claims on paper, make sure the photocopies you attach are clear, easy to read, and for the correct date of service. Many insurance carriers scan the eobs which lightens them a little. If the copy you submitted was already light, by the time the claim is processed it may be sent back to you as unreadable. It takes a lot more time to find the original eob and resubmit a claim than it does to get it right the first time.

Secondary and tertiary claims can sometimes seem like a pain to get paid - especially because they can be for a very small amount of money. It is still important to file and track these claims to keep your receivables under control. It may not seem like a lot of money but it adds up. If you have a system for submitting them it really isn't that bad.

Alice Scott and her daughter / partner Michele Redmond are co-owners of a medical billing service. They offer an informational website for anyone looking for information or help with their problems with medical insurance billing. Here are more articles on submitting insurance claims. You can also sign up for their free monthly newsletter or join their free medical billing forum to get answers to your billing questions.

Cheap Military Auto Insurance Rates - How to Find Military Car Insurance Discounts Online

Is it possible to find a cheap military car insurance rate? What are some things that one should know in order to find the cheapest auto insurance rates for the military? Which insurance companies offer military discounts for their auto insurance policies? If you are in the military or have a family member that is serving their country in the armed forces then it is important to understand some of the various military discounts on car insurance and other money saving perks that are available.

Some insurance companies are offering military car insurance at a discounted rate to all armed forces personnel, including the National Guard. These insurance companies recognize the sacrifice and dedication of the men and women serving this country, and it's their way of showing their appreciation.

These insurers offer a lot of discounts for various military personnel needs, including coverage. In most cases, the military car insurance is being offered to all active and retired military personnel, as well as their families.

USAA, is on the leading edge of providing military car insurance. The company is structured to just serve the needs of the men and women serving in the armed forces. If you become a member of USAA, you and your family can expect to save up to $600 per year for military car insurance. They also offer accident forgiveness. If you are accident free for at least 5 years after purchasing one of their policies, your military car insurance premium will not increase if you have one at-fault accident.

USAA also utilizes 2,300 repair locations nationwide to guarantee repairs will be completed in a timely manner. All of their services, including claims, can be accessed online. They also have a lot of other products and services available to assist service men and women of the armed forces.

GEICO Insurance Company also has a military car insurance program that they offer to all active and retired armed forces personnel and their families. With GEICO you could expect to save somewhere between 2 to 15 percent off your military car insurance. The military car insurance discount is available in all states except Georgia, Indiana, Massachusetts, Michigan, Mississippi, New Jersey, New Mexico, Tennessee, and Texas.

GEICO also allows you to drop all coverage except comprehensive if you are shipped out overseas and plan to put your car in storage. Additionally, if you are deployed to Iraq, Afghanistan, or any other area you receive hostile-fire pay, you can save up to 25% on your military car insurance while your car is in storage.

The Military Assistance team at GEICO is comprised of retired and former military members. They can help you understand and choose the correct military car insurance based upon your needs.

Other car insurance companies, such as Esurance, don't offer a military car discount on your premium, but allow you to cancel your current coverage, without penalty, if the car is going to be in storage while you are overseas. When you return, you can reactivate your policy and Esurance will waive any penalties you might have incurred.

Some cheap car insurance companies will offer great rates but really only offer significant military savings if you are deployed into a hostile-fire zone if your car is stored under one of their approved storage plans.

If you're searching for a good military car insurance program, do some research online, then phone the companies you are interested in. Ask a lot of questions. Don't just take the cheapest rate without knowing the full details and all the benefits you may or may not receive.

Find the best deal for your individual situation and a military car insurance company that you feel comfortable working with. Look for good customer service, online payment and claims filing, as well as how well each company communicates with you.

Of course the #1 way to find the cheapest military car insurance rate is to shop around and compare policies from many different companies. Get started finding cheap auto insurance today!