When billing secondary insurance, the Claim Adjustment Reason Codes provided by the primary insurance must be included.
When secondary insurance is paper billed, the primary EOB would be attached. Since there is no way to attach paperwork when electronically billing, the EOB information must be entered prior to billing. To do so …
- click the [Patient] menu then [Post Insurance Payments]
- highlight the service to be billed to secondary insurance
- click the [Post Adjustmnt] button
- highlight the primary insurances most recent insurance payment or rejection found in the “Insurance Payments and Rejections” box (top)
- enter the claim adjustment reason codes in the “Adjustments from EOB or 835 Response File” box. The claim adjustment reason codes are provided by the primary insurance on their EOB.
- you are now ready to bill the secondary insurance electronically.
When insurance payments and rejections are auto-posted, the claim adjustment reason codes are automatically recorded and none of the above steps would be necessary.