What does "secondary claims" refer to in medical billing?

In the context of medical billing, "secondary claims" specifically refer to claims that are submitted to a second insurer after the primary insurance has been billed. This process typically occurs in scenarios where a patient has dual coverage—meaning they have more than one health insurance plan. The primary insurer is billed first, and after the claim is processed, any remaining balance may then be submitted to the secondary insurer for consideration of payment.

When a patient has multiple insurance policies, understanding the order of billing is crucial. The primary insurance is responsible for covering a certain percentage of the medical costs, while the secondary insurance may cover additional costs, copayments, or deductibles that remain after the primary insurer processes the claim. Properly submitting secondary claims ensures that healthcare providers maximize their revenue by collecting payments from both insurers.

The other options do not accurately represent the definition of secondary claims. Claims related to multiple conditions, denials, or claims that are processed out of order do not capture the specific function and process of secondary claims in billing practices.