Claims: Secondary Claims

Secondary claims are submitted from the Claim Details view after the claim appears in the Pending Submission dashboard. When a secondary claim is ready, click Edit on the dashboard row to open the claim. From there, you can review the information, add any required adjustment reason codes, and submit the claim.

📝 Before You Begin

To ensure your secondary claim appears on the dashboard automatically, verify that:

  • An active secondary policy is saved in the client's profile.
  • The primary remittance has been posted. (For denials, log $0 Insurance Paid and enter the full balance under Client Owes).

✅ To learn how secondary claims automatically appear in your queue, see our Insurance: Pending Submissions Dashboard guide.

In This Article


The Claim Details page includes several tools to help you review and prepare secondary claims.


View Primary / View Secondary Toggle

Use the toggle in the header to switch between the related primary and secondary claims.

The top header of the Claim Details view with a blue arrow pointing to the View Secondary link in the upper right corner.


Secondary Indicators

Secondary claims include labels to help you confirm you’re viewing the correct claim and policy:

  • A Secondary label next to the claim status at the top of the modal.
  • A Secondary Policy label in Insurance > Policy Information, where you can also see the policy’s Effective Date and End Date on both primary and secondary views.

Managing Remittances


What you need to do before submitting a secondary claim depends entirely on how your primary insurance payments are tracked.


Path A: You Receive Electronic Remittances (ERAs)

If your account receives ERAs from the primary payer, no manual entry is required. The system automatically builds the secondary claim with all necessary adjustment and payment data.


Path B: You Enter Remittances Manually

If you manually entered the primary insurance payment, the secondary payer requires an electronic explanation code to account for the remaining balance.

  • Next Step: The system will display a red warning banner stating: "Incomplete Patient Responsibility (PR) adjustments (must add up to patient responsibility amount)." Follow the step-by-step instructions in the next section to resolve this banner.

Adding an Adjustment Reason Code (Manual Remittances Only)


If you are following Path B (Manual Remittances), your adjustment codes must match the remaining balance exactly to clear the warning banner and unlock the Submit button.


Follow these steps to add a reason code:

  1. Open the secondary claim and go to Details > Adjustments.
  2. In the Patient Responsibility section, select Add.
  3. Enter the appropriate Reason Code.
  4. In the Amount field, enter the remaining balance to match the Patient Responsibility total.
  5. Select Save.

#️⃣ Common Reason Codes:

• Approved primary claims:

    • 1 – Deductible Amount
    • 2 – Coinsurance Amount
    • 3 – Co‑payment Amount

• Out‑of‑network denials:

    • 242 – Services not provided by network/primary care providers

Editing Modifiers Before Submitting


If the secondary payer requires modifier changes:

  1. Scroll to the bottom of Claim Details.
  2. Click the blue text link to open the associated bill.
  3. Click the three-dot menu next to the service line.
  4. Select Edit Services to update modifiers.

These changes apply before the secondary claim is submitted.

Finalizing or Removing the Claim


Submitting the Claim

Once you have reviewed the claim details, adjustments, and modifiers:

  1. Click Submit in the top-right corner of the header.
  2. The claim will process and automatically clear from your Pending Submission dashboard.

The top header of the Claim Details view with a blue arrow pointing to the Submit button in the upper right corner.


Removing the Claim

If a secondary claim should not be filed:

  1. Return to the Pending Submission dashboard.
  2. Click Edit on the claim row.
  3. Select Remove.

The system records who removed the claim for audit tracking.

Frequently Asked Questions


How do I filter for secondary claims?

Go to the Pending Submission tab on your Billing page, click Filter, and select Secondary under the claim type options.


Do I need to create the secondary claim manually?

No. Secondary claims appear automatically when they meet the system’s criteria.


Why is the system asking me to adjust patient responsibility?

This occurs when the primary remittance was entered manually. Add the correct reason code so the secondary payer understands the remaining balance.


Do I need to submit a secondary claim if Medicare forwarded it automatically?

No. Auto‑forwarded claims appear in the Submitted tab and do not require manual submission.


For additional guidance on claim submission and remittance workflows, see:

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