What are Secondary Claims in Hindi in Medical Billing BPO RCM by Kunal Jain (Details in Description)

Secondary claims are claims that are submitted to the patient’s second insurance company (if there is one), and the medical practice agrees to submit a claim to the patient’s secondary payer after it has received the allowed portion of the payment from the primary payer.
The primary payer either indicates on the explanation of benefits (EOB) or electronic remittance advice (ERA) that the claim should be printed and submitted to the secondary payer, or the primary payer automatically crosses over the claim. An ERA is essentially an electronic version of an EOB. On this form, important information is recorded regarding payments, denials, adjustments, and reasons for particular actions taken by the payer. We discuss EOBs and ERAs further in Chapter 10: The Payment and Denial Posting Process.
The payers can automatically cross over claims if they maintain a database with information regarding their beneficiaries’ coverage. If a beneficiary is listed with secondary insurance in its database, it automatically transfers the residual financial responsibility to the secondary payer it has on file. Not all payers maintain such a database, and the database is not always
correct.
If the primary payer automatically crosses over the claim to the secondary payer, in what is termed an automatic crossover, the medical practice does not need to generate another claim because the primary payer has already sent it to the second payer. The relationship between the primary and secondary payer is referred to as the coordination of benefits. It can be complex and may require communication with multiple payers to determine which is considered the primary carrier and which is considered the secondary carrier. Furthermore, the patient may also hold tertiary insurance, thus introducing a third payer.
There are often times when your medical practice must submit a claim for the residual financial responsibility to the secondary payer. In this case, the secondary payer requires a copy of the primary payer’s EOB/ERA, and you must attach the primary EOB/ERA to the secondary claim. Depending on the payer, the secondary claim, accompanied by the EOB/ERA, is transmitted electronically or mailed. This is most frequently performed immediately after receipt of the primary EOB/ERA because that is the point at which the primary EOB/ERA is available for duplication and attachment to the secondary claim. You print the secondary claim, attach the primary EOB/ERA, and submit the documents to the secondary payer together. We recommend automating this process with your practice management system, claims clearinghouse, or bolt-on software. (source MGMA)

[@Bavalitared]

Very informative video ❤thanks Kunal sir for your valuable info 👍🏻

[@sappumaurya3391]

Sir continue all medical billing process update on TH-cam in simple language so that I can understand I want to learn and get job in medical billing

[@abhiritu88]

Only MCR crossover the remaining 20% to secondary. For rest, We need to submit at our end. Yes, most of the secondary payers are accepting electronic claims nowadays but that should have primary payment info else it would be denied for primary EOB.