The Secondary Billing Manager in TherapyPM allows you to simplify the handling of claims after the primary insurer has paid. It helps you manage remaining balances and coordinate benefits, ensuring accurate and compliant submissions to secondary insurances.


To manage secondary claims in TherapyPM, please follow the steps below:

  1. Navigate to Billing > Secondary Billing Manager. 
  2. Select the options using the Sort By dropdown. More dropdowns will appear as you choose any option. (Choosing this is optional and not mandatory.)
  3. Click Get Claim(s) to generate the claims table.
  4. Under the claims table, you can view/edit the following information:
    1. Claim: View the claim number (It will redirect you to the HCFA form).
    2. Payor: View the insurance payer type.
    3. Patient: View the patient’s name.
    4. Date Range: View the secondary insurance’s validity.
    5. Total: View the total amount charged for the sessions.
    6. First Billed Date: View when the session was billed first.
    7. Last Billed Date: View when the session was billed for the final time.
    8. Billed to CH: View overall charges billed to the patient – copay, deductible, or coinsurance.
    9. ICN: View the Insurance Claim Number assigned to the claim by the insurance payer. (Editable)
    10. Secondary Auth: View the secondary authorization associated with the claim. (Editable)
    11. Billed Status: View the claim’s billed status (select the status from the drop-down).
    12. Action: Click here for further actions:
      1. View HCFA: Shows you the HCFA form (Alternate method for (a)).
      2. Download EDI: View the HCFA form in EDI format by downloading the file.
      3. Corrected Claim: Edit the claim details and save changes.
    13. Download Icon: Click this option to download the list in CSV or EXCEL format.

 

Drop-down Selections:

For further actions, select the options available in the drop-down menu below the claims table. Before using the drop-down, select the claim(s) using checkboxes.



  1. HCFA with Background: Shows you the entire HCFA form in its original state.
  2. HCFA without Background: Shows only your claim details without the entire background.
  3. Generate 837 File: Shows your claim details in the EDI format.
  4. Push OA SFTP: Sends your claims to the clearinghouse.
  5. Show Detail(s): Shows additional details related to the claims. An additional drop-down is available below this table.
  6. Refresh Secondary Claims: Clears the existing secondary claims table, allowing you to generate a new claims table.
  7. Update Billing Status: Update the billing status of the claim to 'Ready to Bill', 'Submitted', or 'Clarification Pending'.


D. Further Options:

For (5), select the claims using the checkbox(es). Click on the Show Details from the drop-down option to make changes.

  1. Update Modifier: Update the modifiers for the claim.
  2. Update Provider 24J: Update Provider 24J for the claim. 
  3. Copy Modifier from Contract Rate: Copy the modifiers from the contract rate.
  4. Update Place of Service: Update the Place of Service (POS) for the claim. 
     


Video Walkthrough

View the walkthrough video below to learn more about Manage Secondary Billing