Permissions

Users with Billing Permissions can make claim corrections.

Before You Begin

Please check  your claim submission status with the clearinghouse. 

If your claim is not on file with the insurance payer, it is very likely that it was rejected at the clearinghouse level. 

Here is the most common Secondary Claim rejection error you may encounter:

Secondary Claim Information Missing or Invalid (Loop 2430) - Each line must balance; Line Charge Amount (SV102 [HCFA]/SV203 [UB]) = Line sum of Adjustment Amts (CAS) + Line Payer Paid Amt (SVD02)

This means that your secondary claim has not made it to the secondary insurance payer. Your claim has been rejected at the clearinghouse.

Successfully Submit Secondary Claim

In order to successfully submit secondary claims you will need to explain how the primary insurance payer processed the claim.

In TheraNest, this is done with adjustments. 

  1. Navigate to the client's Ledger.
  2. Locate the desired invoice and click Select an Action in the actions column.
  3. Choose View Details from the dropdown menu. 
  4. Add Adjustment

The claim does not need to be marked corrected as it never made it to the payer.

The claim can now be resubmitted to the Insurance Payer.

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