Secondary Billing Instructions in Office Ally

Secondary Billing Instructions in Office Ally

Aloha Secondary Billing:

FYI: 1/24/24 - Secondary billing within Aloha is not available.  The steps in this current article below are to show you how to bill to secondary within Office Ally's site.  We recommend "fake billing" in Aloha so that claims will match and payments can post.

Add a Secondary Payer

Before you do secondary billing, be sure to add the Secondary Payer to your client's profile and add an authorization. Then, select the Secondary Payer from the secondary dropdown list on the Client's primary insurance information after the secondary payer has been entered, and proceed with the following steps below.  


"Fake bill" in Aloha

In the billing tab go to AR Manager 


Then, at the top, where it says “By Payer,” click on the drop down and select “By Client” 
 
 
 
Once you are in Client View, you will double click on the total in the aging for the client that you want to transfer to secondary.  
 

Find the claim that you wish to transfer, then select. Once you have selected the claim(s) that you want to transfer, click “Transfer” and select the payer you want to transfer the balance to (the secondary payer attached to the client should be your only option).  

 

Now, you can to “Fake Bill” to fool the system into showing that the secondary billing claim has been submitted.
 
Keep in mind, that this is only to fool Aloha into believing that it has sent out the secondary billing.  We do not want the claims to go out in the current format as they will most likely be rejected, but if not, they will be denied.  You will need to complete this process in Office Ally.

  1. Go to the Billing tab > Secondary Billing 
  2. Select the claims that will be billed to secondary. Click the edit icon to open up that claim form. 
  3. Edit the claim.   
  4. Using the information from the ERA that you got back from primary, you can add the adjustments that will go to secondary. In the Primary Remittance section, this is where you will enter all the details from the primary ERA/EOB.
    1. Allowed amount - per charge line (this should the total amount that was charged) 
    2. Paid amount - per charge line (this should be 0 b/c it was denied) 
    3. Adjudication date - the date of denial from the primary check (date ERA was issued or the payment was given)
  5. Click the + button in the adjustment section to add group codes, reason codes, and their corresponding amounts. 


Here are some of the most common codes:
Group Codes 
Reason Codes 
CO = contractual adjustment 
PR = patient responsibility 
CR = correction and reversal 
DA = other adjustment 
PI = payer initiated 
45 = contractual obligation
1 = deductible 
2= coinsurance
3 = copay
204 = service not covered 
An easy way to make sure all these numbers were entered correctly is to make sure that the Paid amount + Adjustments = Charge Amount from that charge line. 

6.  Click the "Validate" button at the very bottom once everything has been filled out. Validations help to confirm that the numbers in the Primary Remittance section were entered correctly and checks for any errors. 
OPTIONAL: Click "Save" if you are working on multiple secondary billing claims and you want to save your changes as you are going along before you actually process it. 

7.  Now it is time to tell the system that this has been billed. To do that, make your changes to the claim form, and at the bottom click Submit Claim. You will have three options, but you want to pick of the "paper mail" options. 
     

  

This will make the system think that the claim was sent via mail, but you will actually do it in Office Ally.  

 


 

Bill the claims in Office Ally

 
1. Log into Office Ally. Locate the claim(s) that went to the primary by clicking on “Manage Claims”.  


2. Search for the claim by client and/or date of service and click "View".

3.  Toggle over to secondary.  


4.  Change the payer information that will be on file to secondary payer info AND make sure to change the insured ID (1A) to the secondary payer ID number 


5. Update Box 9 with Primary payer information. Box 9a should have the Primary Payer ID.



6. Scroll down to the secondary payment information.  Enter the primary name and payer ID.

7. Make sure that you enter the adjustments based on the EOB information from the ERA. Careful when you reading the ERA, sometimes they reverse the dates of service. Your dates of service should match the original claim order of chargelines.


8. Once you have confirmed all the information, then click “Send” and the claim has been sent!

You may receive an error message.  Follow Office Ally instructions and error messages to navigate you to the correct box. Any missing information will be highlighted in Orange on the claim. Fill it in and click "send" again.


9.  Make sure that you check back for rejections after 24-48 hours.

 

Posting Secondary Payments

After "fake billing: the claim in secondary billing and billing out in Office Ally, you're now going to wait for the secondary payment to come back.  Aloha doesn't autopost secondary payments at this time, so this would need to be manually added into your Payment Center. 
  1. In Billing --> Payment Center, add the payment received (if instructions for manual posting are needed, click here). Double click the claim to begin posting it.
  2. Search the secondary claim (client and month of service). Transfer every charge line to the payer (from client responsibility) in that claim under Action in the bottom right corner.
    1. Transfer —> Transfer to Payer (amount will automatically populate)
  3. Proceed with posting the secondary payment to each charge line as usual (Allowed, Paid, Contractual Adjustments)
  4. Save. Done! 

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