1. Document the policy information on their Fiscal Face Sheet. How?
2. Submit the claim (only if required by the insurance company, since some are submitted automatically by the primary insurance company.) How?
3. Document the incoming check. How?

Document the Policy Information on the Fiscal Face Sheet

The above screen shows what you would currently see on the client's Fiscal Face Sheet. The assumption with the screen that is displayed above is that you have only added the primary policy information, which is why it says, "1 of 1" at the bottom. To add the second policy, click the little button to the right with the little arrow and orange box (the arrow is pointing to it). When you hover over it, the pop-up help message will say "New (blank) record." Clicking that button will cause a blank insurance form to be displayed where you can enter in the client's secondary insurance information just like you did with the primary information. Note at the center of this screen where it says, "Primary" in the "Prim/Sec" box. That indicates that the first insurance company you entered was the primary policy.

Note that the bottom now says, "2 of 2," indicating that a second insurance record now exists for this client. Click the arrows on the left and right sides of this notation to jump between the primary and secondary insurance screens. You will also notice that the 'add new record' button, the one you clicked to get here, is grayed out, meaning you can't add a third insurance record. You can only have a Primary and a Secondary policy. At the center, click the arrow next to the "Prim/Sec" field and select "Secondary." Then fill in the rest of the information just like you did for the primary insurance policy (How?).

Note: The "Hold" item on the drop-down box will allow you to switch the policies between primary and secondary if you need to by selecting the proper designations from the Prim/Sec drop-down box. For example, if your client previously had BCBS as the primary and Aetna as the secondary, but they now have them reversed, where Aetna is now the primary, you can't just change Aetna to the primary because currently, CILe has BCBS as the primary, and you can't have two primaries. CILe will not allow you to have two at a time. To make this change, change the Aetna to "Hold," then change BCBS to Secondary, and then go back to Aetna and change it to primary. When you come back into this client's Fiscal Face Sheet, the new primary insurance policy will be the first one displayed.

It will also allow you to 'park' a policy for this client temporarily, such as might be the case if they will be changing insurance companies and you want to capture the information in advance. No claims can be created for a policy on "hold."

Submit the claims

There thre three ways you can submit claims using the client's secondary insurance where direct submission is required. Remember that the primary insurance company will often submit the claim themselves, so make sure it is something you need to do before you do so.

1. Submit the claim directly from the session note. How?
2. Document the requirement using the "Claim Stop or Resubmit" listing off of the client's pop-up menu. How?
3. By using the "HICF Claim Form" item off of the client's pop-up menu. This will create a paper CMS 1500 form, which will give you a chance to select the secondary policy. How?

1. Submit the claim directly from the session note.

On the session note screen for the session you want to submit, make sure the "primary" box is unchecked and the "secondaqry" box is checked. When you save or exit that screen, CILe will create an electronic claim if the 'electronic claim' box on the secondary insurance Face Sheet is checked, or list it on the "Sessions with no claims submitted" listing from the Fiscal Menu.

2. "Claim Stop or Resubmit" listing.

On the "Claim Stop or Resubmit" form (which you access from the client pop-up menu), click the checkbox under the "Resubmit Secondary" column for the session note you want to submit. This will cause this claim to show up on the "Sessions with no claims submitted" form (What's that?) off of the Fiscal Menu.

3. Paper Claims

You can also create a paper secondary claim form off of the client's pop-up menu (How?), and it will ask you if you want to produce the claim form using the primary insurance policy. If you say 'no,' it will produce it using the secondary insurance policy.

Document the incoming secondary insurance checks

You document the secondary claims on the same form as you document the checks from the primary insurance checks, but in a different place on the form. From the Fiscal Menu, click "Insurance Payment Maintenance."

Click the "Expand Detail Line" button at the top. This will show a second line for each of the sessions listed, which includes any note associated with this claim, as well as the secondary insurance information.

As you would with the primary insurance check information on the first line, enter the check information for this session on the second line. This total will then show up on the "Deposits to be Done" report (What's that?), documented as "Sec" for secondary insurance. If you check the "EFT" box, that means the money was deposted into your account already via the insurance company's "Electronic Funds Transfer" mechanism, and although you want to document the claim as having been paid, this checkbox will prevent it from being included on the "Deposits to be Done" report.

Note: When you clicked the "Expand Detail" button at the top, the text changed to "Collapse Detail Line." To hide the second line of detail, click this button.