Outpatient Facility Coding Alert - 2008 Issue 9
Billing: New Software May Answer Secondary Payer Woes
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Article Overview
This article addresses operational problems practices face when submitting secondary payer claims in electronic workflows, especially when Medicare is the secondary payer. It discusses how carriers, clearinghouses, and practice management systems affect claim submission, and it references Medicare guidance on secondary payment processing. The piece is relevant to billing staff, coders, revenue cycle teams, and office managers looking for a general understanding of the workflow and system issues involved.
Why This Topic Matters
Secondary payer billing can create administrative delays when systems cannot exchange the needed claim information electronically. Understanding the general workflow issues and the existence of Medicare guidance helps practices evaluate whether their software, clearinghouse, or carrier process needs adjustment.
What You Will Learn
- Why electronic submission can be difficult for secondary payer claims
- How carriers, clearinghouses, and practice management systems affect claim workflow
- What kinds of system workarounds practices may use
- Where the article points readers for Medicare secondary payment guidance
Who Should Read This
- Medical billing staff
- Coders
- Revenue cycle managers
- Practice administrators
- Office managers
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