Does the secondary claim automatically cross over?
Purpose:
To clarify the conditions under which secondary claims are automatically processed after primary claim adjudication.
Scope:
This article covers:
- Prerequisites for automatic secondary claim crossover
- Primary claim status requirements
Excludes: - Manual secondary claim submission
- Payer-specific crossover agreements
- Coordination of benefits setup
Procedure:
- Primary Payer Setup:
- Notify primary insurer about secondary coverage
- Status Verification:
- Primary claim must show:
- Paid
- Denied
- Deductible Applied
- Primary claim must show:
- Automatic Crossover:
- Secondary claim processes after primary adjudication
-
It would cross over automatically if you informed the primary insurance regarding the secondary so that they will update their system.
Note: Secondary payers will only accept secondary claims if the primary claim has been successfully processed by the primary payer with a finalized status of Paid, Denied, or Deductible.
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