How to Submit Claim to Tertiary Payer
Overview
ICANotes+ enables you to submit claims to tertiary payers, with the option to include payment details from the primary and secondary payers.
This article provides instructions on submitting claims to tertiary payer, including how to choose whether or not to include primary and secondary payer details.
Note: Please ensure that the payment details are recorded through ERA/MPP before submitting a claim to the tertiary payer.
Prerequisites
Before submitting to a tertiary payer, ensure your primary and secondary claims are successfully submitted. See Submitting Claims to Clearinghouse for help with the initial submission.
Submit Claim to Tertiary Payer
Claims can be submitted to a tertiary payer from the Billed Encounters tab. The client must have a tertiary payer listed, and the claim must have already been submitted to the primary and secondary payers either through the ERA (Electronic Remittance Advice) or MPP (Manual Payment Posting) process.
Navigate to Billing Worklist > Billed Encounters tab, select a claim and then click the Create Tertiary option from the Actions dropdown.
Note: The option to submit claim to the tertiary payer will be disabled if the claim has been manually moved from the Unbilled to the Billed tab, or if the client does not have a tertiary payer recorded.
The Create Tertiary screen appears as shown below:
Payer: Displays the tertiary payer to which the claim will be submitted. To change the tertiary payer, use the dropdown menu.
Include Primary: By default, the system will send the primary and secondary payer's information, including payment details, to the tertiary payer. If you prefer not to send the primary and secondary payer details, clear the checkboxes.
Save: Click this button to send the claim to the tertiary payer later after reviewing the details. This action moves the encounter to the Unbilled tab. A message will appear as shown below upon saving the details.
Save & Submit: Click this button to submit the claim to the tertiary payer. A success message will confirm submission, or, in the event of an error, a .csv file will be provided to correct the issue and retry the submission process. The following message appears on successfully sending the claim to the tertiary payer.
Include/Exclude Primary/Secondary Payer When Submitting a Saved Claim to Tertiary
When submitting a saved claim to the tertiary payer, the following screen will appear. By default, the system will send the primary and secondary payer's information, including payment details, to the tertiary payer. If you prefer not to send the primary and secondary payer details, clear the checkboxes from the Include P/S column.
FAQs
Can I choose whether to include primary and secondary payer information when submitting a claim to a tertiary payer?
Yes. By default, ICANotes+ includes the primary and secondary payer information, including payment details, when submitting a claim to the tertiary payer. You can clear the checkboxes if you do not want to include this information.
Why is the Create Tertiary option disabled?
The Create Tertiary option is disabled if the claim was manually moved from the Unbilled tab to the Billed tab, or if the client does not have a tertiary payer recorded.
What is the difference between Save and Save & Submit?
Save stores the tertiary claim details for later submission and moves the encounter to the Unbilled tab. Save & Submit immediately submits the claim to the tertiary payer.
What happens if a tertiary claim submission fails?
If the submission encounters an error, ICANotes+ provides a .csv file that you can use to correct the issue before retrying the submission.
Can I change the tertiary payer before submitting the claim?
Yes. On the Create Tertiary screen, you can select a different tertiary payer using the Payer dropdown.
When submitting a previously saved tertiary claim, can I still choose whether to include primary and secondary payer details?
Yes. When submitting a saved tertiary claim, you can include or exclude the primary and secondary payer information by selecting or clearing the checkboxes in the Include P/S column.
Need Help?
📞 Phone: 443-203-5857
📱 Text: 866-301-0085
📧 Email: ticket@icanotes.com
💬 Chat: https://app.icanotes.com
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