--- title: Submitting secondary claims in Pabau description: "Bill a client's second insurance after the primary pays: find claims due, record a paper payment, create the secondary claim and track or resubmit it." --- [Skip to content](https://support.pabau.com/en/pabau2/submitting-secondary-claims-in-pabau#main-content) [![pabau logo white](https://support.pabau.com/hubfs/pabau%20logo%20white.svg)](https://support.pabau.com/en/pabau2?hsLang=en) Open main navigation Close main navigation - [Get Support](https://pabau.com/support-center/) [Get Support](https://pabau.com/support-center/) Pabau Knowledge Base - There are no suggestions because the search field is empty. 1. [Pabau Knowledge Base](https://support.pabau.com/en/pabau2?hsLang=en) 2. [Insurance Billing](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en) 3. [Insurance Billing (US)](https://support.pabau.com/en/pabau2/insurance-billing?hsLang=en#insurance-billing-us) # Submitting secondary claims in Pabau ## How do you bill the second payer after the primary pays? When a client has two insurance policies, you bill the primary first. Once it pays, you bill the secondary payer for the balance the primary didn't cover. Pabau carries the primary payer's payments and adjustment codes onto the secondary claim for you, so the second payer gets the coordination-of-benefits detail it needs without anything being typed twice. **NOTE:** Insurance billing is available for practices in the United States. Claims go to payers electronically through the Claim.MD clearinghouse, using your own Claim.MD account. **NOTE:** A secondary claim is created from the primary claim after the primary has paid. You need: • The primary claim settled as **Paid**, with the primary payer's line-by-line result (each line's paid amount and adjustment codes). That comes from the payer's electronic remittance (ERA), or from a payment you record by hand (see Step 2). • The client's second policy: the payer and the member / policy number on the second card. Adding it to the client's **Insurance** tab first saves typing later. **Step 1: Find Claims Ready for a Secondary** On **More → Claims**, two chips above the list keep the secondary work in one place: 1. **Secondary due**: paid primaries where the client has another policy and no secondary has been sent yet. 2. **Secondary rejected**: secondary claims the clearinghouse or payer turned back, waiting for you to correct and resend. ![The More → Claims list with the Secondary due and Secondary rejected chips marked](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444678339777-01-secondary-chips.png) *The secondary worklist chips* **Step 2: No ERA From the Primary? Record the Payment** Some payers pay on paper or by phone and never send an electronic remittance. The claim would then sit on **Submitted**, and you couldn't bill the secondary, which needs the primary's result. To settle it by hand, open the submitted primary claim, scroll to **Record payer payment** and fill it in from the EOB: 1. **Payment date**, plus the **Payer claim ref** if the EOB shows one. 2. **Paid**: what the payer paid on each charge line. 3. **Adj group**: the group for any amount the payer didn't pay, such as CO or PR. 4. **Adj code**: the reason code (for example 45), with its **Adj amt**. 5. Click **Record payment**. ![The Record payer payment window with payment date, paid amount, adjustment group, adjustment code and Record payment marked](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444163369165-03-record-payer-payment.png) *Record the primary payment from the EOB* The claim settles as paid with the same line-by-line detail an ERA would carry, so you can bill the secondary straight away. This settles the claim for tracking and secondary billing only; posting the money onto the invoice stays your normal payment step. More in [How to record a payer payment or denial from a paper EOB](https://support.pabau.com/en/pabau2/how-to-record-a-payer-payment-or-denial-from-a-paper-eob?hsLang=en). **Step 3: Create the Secondary Claim** 1. Open the paid primary claim from **More → Claims** (or from **Secondary due**). 2. In the claim's status bar, the one that starts with **Paid**, click **Create secondary claim**. It appears only once the primary is paid with its line-by-line result on file. 3. If the client has another policy on file, pick it under **Client's second policy** and Pabau fills in the payer and member number. Otherwise choose the **Secondary payer** and enter the **Secondary member / policy number** and, if the card has one, the **Group number (optional)**. 4. Set **Medicare secondary (MSP) type** only when Medicare is the secondary payer. It tells Medicare why it pays second, and Medicare rejects the claim without it. For every other payer, leave it on **Not Medicare / not applicable**. 5. Click **Submit secondary claim**. Pabau sends the claim to Claim.MD as a secondary, with the primary payer's paid amount and adjustment codes on each service line. That is the coordination-of-benefits information the second payer uses to work out what it owes. **IMPORTANT:** Some primary payers pass the claim on to the secondary themselves (a "crossover", common with Medicare). When the primary's remittance says it did, Pabau shows **Record as forwarded** instead of **Create secondary claim**. Use it to mark the claim as handled; sending your own secondary as well would bill the second payer twice. **Step 4: Track the Secondary** The secondary rides on the primary's claim, so there is no separate record to hunt for: 1. **Related claims** shows the secondary claim and where it stands, for example **Submitted**, awaiting the payer's response. 2. In **Submissions & Acknowledgements**, every event for the second payer carries a **Secondary** tag, so you can tell the two payers' replies apart. ![A paid primary claim with the Related claims card and a Secondary tag in the submission history marked](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444678339777-02-secondary-tracking.png) *The secondary is tracked on the primary claim* The status bar also shows both results side by side: the primary's **Paid**, then **Secondary:** with the second payer's status as it moves from Submitted to Paid, Rejected or Denied. When the secondary's remittance arrives, it is matched to the same invoice. ![The claim status bar showing the primary as Paid and the secondary as Submitted](https://support.pabau.com/hubfs/Pabau%202%20Knowledge%20Base/kb/obc-2026/444678339777-03-status-strip.png) *Primary and secondary, side by side* **What Gets Carried Across** - **The primary's result**: each line's billed, allowed and paid amounts and the payer's adjustment reason codes, taken from the ERA or the payment you recorded. - **The claim itself**: patient, rendering provider, diagnoses and service lines all come from the primary claim. All you add is the second payer and the member / policy number. **Step 5: If the Secondary Is Rejected** Secondary claims carry strict coordination-of-benefits maths, so a second payer can turn one back over the figures rather than the care. Two common causes: the primary payment date must be on or after the date of service and not in the future, and on each line the primary's paid amount plus its adjustments must add up to the full charge. 1. Open the claim from the **Secondary rejected** chip and read the reason beside the secondary's status. 2. If the recorded primary payment is off, correct it. 3. Click **Resubmit secondary claim**. It updates the same claim at Claim.MD rather than creating a duplicate. **What's Next?** - [Insurance Guide Part 4: Submit and track insurance claims](https://support.pabau.com/en/pabau2/insurance-guide-part-4-submit-and-track-insurance-claims-in-pabau?hsLang=en) - [Billing Medicare as the secondary payer](https://support.pabau.com/en/pabau2/billing-medicare-as-the-secondary-payer?hsLang=en) - [Handling a crossover claim (when the primary forwards it on)](https://support.pabau.com/en/pabau2/handling-a-crossover-claim?hsLang=en) - [Resubmitting a rejected secondary claim](https://support.pabau.com/en/pabau2/resubmitting-a-rejected-secondary-claim?hsLang=en) - [How long does it take to process ERA and claims?](https://support.pabau.com/en/pabau2/how-long-does-it-take-to-process-era-and-claims?hsLang=en) - [Understanding claim statuses on the Insurance claims list](https://support.pabau.com/en/pabau2/understanding-claim-statuses-on-the-insurance-claims-list?hsLang=en) Questions about a specific secondary claim? Reach us any time via the in-app chat. We're happy to help. --- Was this guide helpful? Let us know by voting below - your feedback helps us write clearer articles. For **[more guides](https://support.pabau.com/en/pabau2?hsLang=en)**, browse the related articles below or use the search bar at the top of the page. 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