FAQs

Why Don’t My Secondary Claims Crossover? The terms “MSP” and “COB” are found in heavy use these days, but getting the claims paid seems more difficult than ever. Many payers no longer accept secondary claims on paper, some can’t receive electronic claims yet, and all struggle with updating their systems to be compliant with current HIPAA legislation. The main question is this: if my EOB from the primary payer states “Claim information forwarded to …” why don’t I get paid? For the most part it is a matter of provider identification. If the primary payer receives NPI only to identify you, that’s all they can forward on to the secondary payer. If the secondary payer needs a PIN number to identify you, the claim may reach them but they don’t know who to pay. Another problem that affects the payment process is standard codes for adjustments and denial reasons. Many times the primary payer’s EOB contains proprietary codes to explain the payment details, and the other payer needs standard codes. The third item of concern is the most difficult for most providers to solve. In the past, secondary claims were filed by printing a copy of the primary claim, attaching a copy of the primary payment EOB and mailing them to the secondary payer. Claims were paid on a claim-level basis, which means one total for the entire claim, regardless of the number of services billed. Now the data describing the insured has to appear in opposite areas of the claim for the destination payer than it does for the other payer. Furthermore, all details regarding payment have to be broken down on a line-level basis, which is service by service. In order to meet the current requirements, all secondary claims must include:
  • payment date
  • payment amount
  • allowed amount
  • adjustment reason
  • adjustment group
  • adjustment amounts for up to four adjustments per line of service.
Also included are:
  • total paid amount
  • total allowed or approved amount
  • payment date
If your practice management system cannot store these details on a line-level basis, it will be difficult to file successful secondary claims that get paid with a minimum of fuss. SolAce EMC Products have been used to successfully file secondary and MP claims since early 2005. The process of creating a patient record and preparing a secondary claim is extremely easy and can be done in just 2 or 3 minutes. For more information on training for secondary claims, please mail webdemo@solace-emc.com.

customer Testimonial

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customers From our customers

I am very pleased with our SolAce billing software and how easy it is to navigate. They have a great team who can train you to do billing even if you don’t have billing experience. Special thanks to Cathy, Gigi, and Skyler who always helps me out every time I have issues.

Shani Madaminova,
Administrator
Best Home Care, Inc
Jersey City, NJ

SolAce is awesome software. I absolutely LOVE it. For over three years I have used this software daily for multiple long term care facilities to submit claims to various MACs, Medicaid, and Medicare Advantage and Supplemental Insurance carriers. It is convenient, simple to use and far less costly than any Clearing House software I had explored. The ability to import from my Practice Management Software and Therapy Providers has reduced any RTP claims edits and denials are a thing of the past. Customer Support is “Johnny on the spot”, but terrific as they may be, it gets better - RARELY do I need to call. LOVE IT, LOVE IT, AND LOVE IT.

Susie Doran Carter, Westcare Management, Inc.
LTC Medicare Consultant and Billing Service
Salem, OR

I think our medical office was one of the first to use SolAce in the mid 1990’s and we are still using it today for all of our electronic billing because it works ! It was simple for our staff to learn and it integrated easily with our accounting/billing program. It has been especially nice to know that the Axiom staff is there when Medicare changes something and they are right on it. They made the 5010 change a simple process plus made educational seminars available to us. Thank you to all the Axiom/ Ivertex professionals who have helped us for the last 15+ years.

Carolyn Boles
From the office of Donald J. Boles Jr. MD PC
Tempe, AZ

SolAce has been a valuable tool that has been a life saver for my billing service for years. It has allowed me to bill professional and institutional claims with ease. Customer service @ SolAce is top rated in my opinion. The SolAce product is very user friendly and affordable. Thank you SolAce team for a great product.

S. Bowling
Idabel, Oklahoma

Easy to use, Customer support has always been excellent, Thanks SolAce Team.

Carl Shepherd
IT Administrator
THE WYNN GROUP, INC
Dublin, GA

I am a new client and was having a tough time getting everything set up just right. I had to make calls to CEDI and when I called back the rep I spoke with prior even helped the 2nd rep to make sure I got all the info I needed. They definitely work as a team. Within a short period of time they had my system up and running. I never could've done it without them.

Denise
Margate, FL

Awesome customer service every time!

Denise
Bellevue, NE

I can't tell you how wonderful it is to work with your agency. They are courteous, knowledgeable,friendly, and a joy to work with - I can't say enough. Thank you!!

Doreen
Bemidj, MN

The service was very good. Phone answered promptly even though it was around 6 p.m. my time. Very courteous and helpful. So far I have had really good experiences with your support team.

George
Mahornet, IL

The follow-up is outstanding - whenever there is an issue I am contacted to be sure that all is working well and to my satisfaction.

Joan
Batavia, IL

Everyone in your company is very helpful and pleasant, and they always have the quickest response time on fixing the situation.

Patricia
Orlando, FL

Tech was very helpful, very patient and very professional. She knew of the issue quickly and stayed at hand until issue was resolved. Very satisifed with the service.

Sherry
Largo, FL