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bgalofredds
Canine III

How do I electronically submit a secondary Pre-determination

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I'm so glad to have this forum to ask these questions.

I've been sending  of primary pre-determinations just fine for several years, but would like to submit to the secondary insurance once the primary has responded with its EOB.

When I try to submit it now it informs me that my primary hasn't been completed and to print it out.

Can I send it electronically? I think it would be much faster.

Thanks

Mark

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9 Replies
chriscornett
Premolar II

Re: How do I electronically submit a secondary Pre-determination

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bgalofredds‌, try the steps in the attached document. It should give you step by step instructions on how to submit the secondary pre-authorization.

Feel free to print the above document out if you like

drcavola
Premolar III

Re: How do I electronically submit a secondary Pre-determination

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Just keep in mind that Softdent has you process/handle printed claims, electronic claims, and pre-authorization claims all in the same manner, especially when it comes to dual insurance.  That is, primary is submitted, received, processed in your office, and then submit the secondary claim.  That is the mindset.  Logically a primary claim needs to be completed before a secondary claim can be submitted.  So, it's easy when you have a paper check, a little bit more tricky when you have an EFT payment, and even a little bit more trickier when you just have a primary "pre-authorization" to complete the claim and "force" (gently please ) Softdent to generate the secondary claim.  Thus the reason to post a 2.x transaction code in order for Softdent to prompt you about the final "payment" of the primary claim.

mdunham
Premolar III

Re: How do I electronically submit a secondary Pre-determination

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Create a code that will "close out" a claim such as 2.(something) you can post this in the tx plan area or in the

ledger , add the remittance to a claim just like you would an ins check.   Once you hit " is this the final payment for primary" Softdent will ask if you want to submit to Secondary.  Click "yes", and secondary wil be submitted with your Primary attachments in Tow.     I also created a codes 2.6-App 2nd, 2.7 Deny 2nd, 2.5-app primary, 2.4-App Primary .   This allows me to quickly see if group number was accepted or denied .    Let me know if you need additional help.    

This is also a great great way to keep trac of your preD in reporting 

drzatko721
Canine II

Re: How do I electronically submit a secondary Pre-determination

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Help! I have created the prior auth in SoftDent. However, when going to print the secondary insurance claim for the prior auth DoftDent is saying No Claim found. What's happening? 

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mdunham
Premolar III

Re: How do I electronically submit a secondary Pre-determination

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Have you marked the primary as returned?  If the primary claim is not marked returned/Complete, Softdent will not see it as a claim to be found.   

HInt:    If the Primary has not returned, you generally do not have to wait.  You can simply mark the claim "complete" on the Status tab of the claim.   This will prompt Softdent to send the claim to Secondary.   If electronic attachments are needed, you can simply reference the Primary NEA attachment on the claim form rather than submitting again.   I hope I helped you! 

drzatko721
Canine II

Re: How do I electronically submit a secondary Pre-determination

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Thank you so much for getting back to me! I went and marked the primary as returned and went to print the secondary claim, however, primary information is still coming up. Secondary info is on the claim but not showing in correct boxes when trying to print the claim. Any ideas? 

mdunham
Premolar III

Re: How do I electronically submit a secondary Pre-determination

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This could be a "glitch"  and you may need to delete the claim and resend.  If you do this simply hit send to primary and then select the COMPLETE BOX, which of course should send on to secondary.  TIP!  write down your NEA number so you can add to new claim. 

OR! 

You may want to be sure you have the plan address and information set up correctly on the mailing tab of the plan.  If so, also be sure that you have it set up to send as ECS compatible as well as NEA able. 

I have a feeling that it is a glitch as the same thing happened to me last night.   

drzatko721
Canine II

Re: How do I electronically submit a secondary Pre-determination

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Thank you again for all your help! I finally got it to work!!!! 

mdunham
Premolar III

Re: How do I electronically submit a secondary Pre-determination

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Also, FUN TIP!!!!!!!!  on pre-authorizations, you do not need to wait until Primary remits a preD to send Secondary PreD.  Secondary policies do not COB on PreD's, therefore, it does not matter if they have primary EOB.  They only need Primary information.    

To do this simply send all information and electronic NEA to Primary, retrieve NEA number, then mark the COMPLETE box on the STATUS tab of the claim.  Softdent will then mark Secondary as payor on the claim.   Reference your NEA number in notes box and send electronically to Secondary.