Tips for setting up secondary insurance in your practice management software

Tips for setting up secondary insurance in your practice management software

Tips for Setting Up Secondary Insurance in Your Practice Management Software

Setting up secondary insurance correctly in your practice management software is essential for accurate claim submission, proper payment tracking, and patient satisfaction. Small setup errors can lead to denials, delayed payments, or incorrect patient billing. The following tips will help ensure your system is configured properly for handling secondary claims.

1. Verify Dual Coverage at Every Visit

Before updating your software:

  • Ask the patient if they have more than one active insurance policy

  • Request both insurance cards

  • Confirm which is primary and which is secondary

Why it matters: Proper identification prevents incorrect claim routing and denials due to coordination of benefits (COB) issues.

2. Enter Insurance Plans in the Correct Order

In most practice management systems, insurance payers are assigned in tiers or levels:

  • Primary = Payer 1

  • Secondary = Payer 2

  • (Tertiary = Payer 3, if applicable)

Tip: Do not reverse the order—even if the secondary plan offers better coverage. Payers follow COB rules, not benefit richness.

3. Match Subscriber Information Accurately

Each insurance entry should include:

  • Subscriber name

  • Relationship to the patient

  • Date of birth

  • Policy and group number

  • Insurance company and claims address

Important: Errors in subscriber details can cause mismatches and rejections from the clearinghouse or payer.

4. Update Coordination of Benefits Information

Some software systems have a designated COB field or checkbox:

  • Input the start date and coverage order

  • Include end dates for inactive plans

  • Check for payer-specific COB setup requirements

Why it matters: If COB data is missing or outdated, the secondary payer may automatically deny the claim.

Ensure the system knows which charges to bill to each payer:

  • Assign both insurance plans to the patient account

  • Ensure claim generation rules are set to bill the secondary only after the primary pays

  • Enable automatic creation of secondary claims once the primary EOB is posted (if supported)

Tip: Review software settings with your vendor or IT team to ensure proper automation.

6. Store and Manage EOBs for Secondary Submission

Some software allows you to:

  • Scan and attach primary EOBs to claims

  • Import electronic remittance advice (ERA)

  • Auto-populate payment fields for secondary billing

Best practice: Keep a digital record of all primary EOBs in case they are needed for secondary claim submission or appeal.

7. Use Notes and Flags for Billing Staff

  • Add internal notes for each patient with dual insurance

  • Use billing flags or alerts for secondary payer follow-up

  • Note any crossover or non-standard billing arrangements

Why this helps: It ensures continuity and accuracy across your billing team, especially if multiple staff members work on the same account.

8. Test Before Going Live With New Setups

If you’re adding a new payer or updating software:

  • Test the claim flow with both primary and secondary insurers

  • Validate that claims transmit in the correct order

  • Confirm that balances and adjustments are calculated properly

Tip: Use test patients or a dummy account to simulate real scenarios without risking denials.

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