Billing secondary insurance

Secondary billing starts from Claims or the patient's Claims tab after you open the patient from Patients, once the primary payer has adjudicated the claim. Ona creates a new draft claim for the patient's other policy and opens it for review before you submit it.

How do I bill a secondary payer?

In the left sidebar, click Claims. Use Claims to bill the remaining balance of an adjudicated primary claim to the patient's other insurance policy. This creates a new secondary draft; it does not resubmit the primary claim.

1. In the left sidebar, click Claims.
2. Select the adjudicated primary claim.
3. Open the claim action that shows Bill this balance to the secondary payer?.
4. Review the patient, payer and PCN shown in the message.
5. Select Create secondary claim.

Ona creates the secondary draft, closes the primary claim, opens the new draft in edit mode, and shows Secondary claim created. The patient is not invoiced until the second payer rules.

How do I finish the secondary draft?

In the left sidebar, click Claims, then select the secondary draft. The secondary draft opens for review, and you need to set the filing code before it goes out.

1. Review the new draft that opens after the secondary claim is created.
2. Set Filing code (plan type).
3. Review the draft details and any validation alerts.
4. Submit the draft when it is ready.

The secondary claim moves forward as its own claim, with its own PCN and history.

How do I handle No second insurance on file?

In the left sidebar, click Claims, or click Patients, click the patient's name, and click Claims in the patient sidebar. Use this place when Ona shows No second insurance on file during secondary billing. This means the patient does not have secondary coverage available on their record.

1. Select Close.
2. Add the patient's secondary coverage to their record.
3. In the left sidebar, click Claims, then select the primary claim.
4. Try the secondary billing action again.

Trying again before adding the patient's secondary coverage will not change the result. For help with coverage records, see Patient insurance and card scanning.

How do I open a secondary claim that was already filed?

In the left sidebar, click Claims. Use Claims when Ona shows Secondary already filed. This means the primary claim's balance has already been billed to the other payer.

1. Select the primary claim, then open the secondary billing action.
2. In the Secondary already filed message, select View secondary claim if it appears.
3. Review the secondary claim that opens.
4. Continue work from the secondary claim instead of creating another one.

Ona prevents duplicate secondary billing for the same primary balance.

What can't I do here?

In the left sidebar, click Claims. In Claims, secondary billing is limited in these ways:

• Clinicians do not use the claims queue for this workflow.
• If insurance billing is turned off for your organization, the claims pages are not available.
• You cannot bill a secondary when the patient has no second insurance on file.
• You cannot create another secondary claim after the primary balance has already been billed to the other payer.
• You cannot bill a secondary from a claim that is not adjudicated.
• You cannot bill a secondary from a claim that is already a secondary claim.
• Creating the secondary claim does not invoice the patient. Patient billing waits until the second payer rules.

Common questions

Is a secondary claim the same as a resubmission?

No. Secondary billing creates a new claim against the patient's other policy. It is not a resubmission of the primary claim.

What happens to the primary claim?

When the secondary draft is created, the primary claim is closed. Work continues on the new secondary claim.

Why do I need to set the filing code?

The secondary draft needs its filing code reviewed before submission. Set Filing code (plan type) before you submit the claim.

Will Ona invoice the patient when I bill the secondary?

No. The patient is not invoiced until the second payer rules.

What should I do if the claim says it was not found?

Refresh the claims list. The claim may have been deleted.