Ability to Submit Claims to the Tertiary Payer 

ICANotes+ enables you to submit claims to tertiary payers, with the option to include/exclude payment details from the primary and secondary payers.  Please ensure that the payment details are recorded through ERA/MPP before submitting a claim to the tertiary payer.

Submitting 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 both the primary and secondary payers, with payments processed 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. 

Create Tertiary Payer: Displays the tertiary payer to which the claim will be submitted. To change the tertiary payer, use the Tertiary Insurance dropdown. The Member ID field will be automatically populated based on the selected tertiary insurance.

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.

Include/Exclude Primary and Secondary Payer Details When Submitting a Saved Claim to Tertiary

Rebilling a Tertiary Claim

When rebilling a tertiary claim, the Claim Frequency Code and Payer Claim fields function the same as they do when rebilling a primary or secondary claim. The Include Secondary checkbox is updated to Include Other Insurance. When a tertiary insurance is present, it is displayed along with a chip indicator.