How to Submit Claim to the Tertiary Payer

How to Submit Claim to the Tertiary Payer

Overview

This article walks you through submitting a claim to the tertiary payer in Billing Worklist.

See Also

Before submitting a claim to the tertiary payer, make sure the claim has been successfully submitted to the primary and secondary payers. For more information, see:

Submitting a Claim to the Tertiary Payer

After the claim is submitted to the secondary payer, billers can post the secondary payment through ERA (Electronic Remittance Advice) or MPP (Manual Payment Posting).

The primary and secondary payments must be posted before the claim can be submitted to the tertiary payer.

After the secondary payment is posted, the remaining balance is transferred to the tertiary payer, and the claim status changes to Ready for Tertiary.

Finding Claims Ready for Tertiary Submission

Claims with a Ready for Tertiary status appear in the Ready bucket.




Submitting the Claim

After the claim has a Ready for Tertiary status, submit it to the tertiary payer.

After you submit the claim, a success message appears, and the claim moves to the Billed bucket.



Viewing the Submitted Claim in the Billed Bucket

After the claim is successfully submitted to the tertiary payer, it appears in the Billed bucket.



Reviewing and Fixing Tertiary Claim Errors

If the claim cannot be submitted to the tertiary payer, it moves to the Error bucket.

The claim can have either of the following statuses:

  • Ready for Tertiary - Validation Failed

  • Ready for Tertiary - Submission Failed





Review and fix the errors, then submit the claim again.


FAQs

When can I submit a claim to the tertiary payer?
You can submit the claim to the tertiary payer after the primary and secondary payments have been posted and the claim status changes to Ready for Tertiary.

How can I post the primary and secondary payments?
Payments can be posted through ERA (Electronic Remittance Advice) or MPP (Manual Payment Posting).

Where can I find claims that are ready for tertiary submission?
Claims with a Ready for Tertiary status appear in the Ready bucket.

What happens after I submit a claim to the tertiary payer?
A success message appears, and the claim moves to the Billed bucket.

Where can I find a tertiary claim that could not be submitted?
A claim that cannot be submitted to the tertiary payer moves to the Error bucket.

What statuses can a tertiary claim have when it moves to the Error bucket?
The claim can have either Ready for Tertiary - Validation Failed or Ready for Tertiary - Submission Failed.

What should I do if a tertiary claim fails?
Review and fix the errors, then submit the claim again.

Where can I find instructions for submitting a claim to the primary payer?
See How to Submit Claim to the Primary Payer.

Where can I find instructions for submitting a claim to the secondary payer?
See How to Submit Claim to the Secondary Payer.


Need Help?

For further assistance, contact:
📞 Phone: 443-203-5857
📱 Text: 866-301-0085
📧 Email: ticket@icanotes.com
💬 Chat: https://app.icanotes.com

Proprietary Notice Information: This article is provided for informational purposes only, and the information herein is subject to change without notice. While every effort has been made to ensure that the information contained within this article is accurate, ICANotes cannot and does not accept any type of liability for errors in, or omissions arising from the use of this information.