Primary and Secondary Insurances-Create EDI 837p 5010 Claim for a Client

Primary and secondary claims must be sent separately. Once the primary payer sends a remit on the claim, you can file a claim to the secondary payer. For the secondary claim to be paid electronically, the payer must accept secondary claims. You can verify that through ConnectCenter >> Payer Tools >> Payer Search. Those that have the green check mark under the column labeled 2nd CL, indicate that they accept them. The PayerFinder API indicates Y or N.

The primary claim information goes in otherPayerName and otherSubscriberInfomation, and the active payer details are submitted as normal. We do not have any documentation on what is required for secondary claims as this would be billing-specific and situational information.