---
title: "How do I handle secondary and tertiary claims?"
slug: "how-do-i-handle-secondary-and-tertiary-claims"
tags: ["Secondary", "Primary Payer", "View and Edit Claims", "How to"]
updated: 2026-08-19T18:45:11Z
published: 2026-08-19T18:45:11Z
canonical: "docs.claim.md/how-do-i-handle-secondary-and-tertiary-claims"
---

> ## Documentation Index
> Fetch the complete documentation index at: https://docs.claim.md/llms.txt
> Use this file to discover all available pages before exploring further.

# How do I handle secondary and tertiary claims?

**Question**: How do I handle a cross-over claim?

**Answer**: You would bill the Primary Payer first, then check the primary payer's EOB/ERA and verify that they have not already forwarded the claim to the secondary payer.

**Question**: What if I checked the EOB/ERA, and the payer did not forward the claim to the secondary payer?

**Answer**: If the Primary Payer does not auto-cross over claims for you, once you get paid by the Primary Payer, then you would need to submit a claim to the Secondary Payer.

Blue Cross Blue Shield / Blue Plan Secondary ClaimsWhen Medicare is primary and a Blue Cross Blue Shield or other Blue plan is secondary, providers may need to wait **at least 30 days** before submitting the secondary claim.

### To submit an electronic Secondary Claim in Claim.MD

Multi-Payer Support

Claim.MD includes multi-payer support, including support for tertiary claims. When you select the **Payer Order** field, Claim.MD loads the payers currently associated with the claim into the **Edit Payer Order** window. Each row displays the payer name and payer ID, along with a **Payer Order** dropdown that identifies the payer as **Primary**, **Secondary**, or **Tertiary**.

The window title identifies the destination payer order being edited, such as **Destination SECONDARY**. Review the payer assignments, select the appropriate order for each payer, and then click **Apply**. The payer assigned to the selected destination order is moved into the corresponding destination payer fields on the claim form.

![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1787159481596.png)

1. [Search](/v1/docs/how-do-i-handle-secondary-claims#searching-for-secondary-claims) for the Primary claim. This should be the claim you would like to submit to a secondary insurance.
2. Enter the correct secondary Payer Name/Payer ID.  
![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1787164302227.png)
3. Select the **Payer Order** field at the top of the **View/Edit Claim** page. The **Edit Payer Order - Destination SECONDARY** window loads the payers currently associated with the claim. Use the dropdown beside each payer to confirm or change its order. Make sure the payer that should receive the secondary claim is assigned **Secondary**, then click **Apply**. Claim.MD moves that payer into the secondary payer fields on the claim form.Institutional ClaimsPlease note that the same process applies to Institutional (UB-04) Claims. For secondary claims, the **Payer Order** field used to open the **Edit Payer Order** window is located further down the form under Payer Name (Box 50).![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1727812396862.png)
4. Fill in any required information displayed in red fields. In this example, you need to complete the following fields: the Insured I.D. Number in box 1a, the Secondary Insured Name, the Secondary Insured's Policy, the Secondary Payer Name, and the Secondary Relationship.  
![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1787165097311.png)  
ADJUSTMENT REASON CODENote that when the claim destination is assigned **Secondary** or **Tertiary** in the **Edit Payer Order** window, the Adjustment Reason Code fields will display below line 24. In these fields, enter the adjustment code, the adjustment amount, the Remit Date, and what has already been paid.  
![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1690912944598.png)**Please also note, that if the primary payer is enrolled for ERA in Claim.MD, it will auto-fill the ERA codes and payments / reje****ctions if there are any ERA received for the primary claim.**UB04 Primary Payer Claim ID Mapping (Box 64 Bottom Field)

For Facility Claims (UB04), the Primary Payer Claim ID is reported in Box 64. The value for the **bottom** field in Box 64 can be submitted in the JSON file format using the following field:

`icn_dcn_2`

This field is used to populate the Primary Payer Claim ID for secondary claim submissions. ![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1778602047823.png)
5. Click ![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1682976930537.png) to submit to the secondary payer.

### Check ERA Associated with Claim

To check to see if ERA is associated with a claim, click on the [Show History / Notes](/v1/docs/viewediting-archive) button on the bottom right corner and search for the EFT/Check#![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1718991023572.png).

### Searching for Secondary Claims

To search for a secondary claim:

1. Click in the **Search** page in the left navigation menu.
2. Enter as much detail as needed in the Search fields to find the specific claim or group of claims.

![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1683234343776.png)

To make it easier to find and differentiate the primary and secondary claim, a "**2**" will be displayed in the last column next to the secondary claim.

![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1683234535727.png)

### Show History / Notes for Secondary Claims

- If there is a secondary claim, the **Show History / Notes** for the secondary claim will have a link in the Event column notifying that it is "**associated with another claim**". Click on the link to bring you to the primary claim associated with it.
- Similarly, the Primary claim will have a "**New Claim Created from this Claim**" link in its **Show History / Notes**. Click on this link to view the Secondary Claim.

![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1683235123853.png)

## Handling Tertiary Claims

Handling tertiary claims is almost exactly the same as creating secondary claims. The multi-payer interface loads the payers currently associated with the claim and allows you to assign each payer as **Primary**, **Secondary**, or **Tertiary**.

Make sure a [secondary claim](/v1/docs/how-do-i-handle-secondary-claims#to-submit-an-electronic-secondary-claim-in-claimmd) is already created and [search](/v1/docs/how-do-i-handle-secondary-claims#searching-for-secondary-claims) for the claim.

1. Enter the correct tertiary  Payer Name/Payer ID.  
![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1787165007339.png)
2. Select the **Payer Order** field at the top of the **View/Edit Claim** page. In the **Edit Payer Order** window, use the dropdown beside each payer to confirm or change its order. Make sure the payer that should receive the tertiary claim is assigned **Tertiary**, then click **Apply**. Claim.MD moves that payer into the tertiary payer fields on the claim form.
3. Fill in any required information displayed in red fields. In this example, you need to complete the following fields: the Insured I.D. Number in box 1a, the Secondary Insured Name, the Secondary Insured's Policy, the Secondary Payer Name, and the Secondary Relationship.  
![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1787164654031.png)ADJUSTMENT REASON CODENote that when the claim destination is assigned **Secondary** or **Tertiary** in the **Edit Payer Order** window, the Adjustment Reason Code fields will display below line 24. In these fields, enter the adjustment code, the adjustment amount, the Remit Date, and what has already been paid.  
![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1690912944598.png)**Please also note, that if the primary payer is enrolled for ERA in Claim.MD, it will auto-fill the ERA codes and payments / reje****ctions if there are any ERA received for the primary claim.**
4. Click ![](https://cdn.document360.io/367e6528-88da-4443-9da1-fcdd7e6d4d49/Images/Documentation/image-1682976930537.png) to submit to the tertiary payer.

## Troubleshooting SVD01 and 2330B Mapping

In your 837, the issue is with how the SVD01 elements are being used in relation to the 2330B loops.

### How SVD01 and 2330B Work Together

- Each 2330B loop represents one other payer, such as primary, secondary, or tertiary.
- Within the payment information, the SVD segment is used to report how that specific other payer paid and adjusted the line.
- SVD01 is the key that ties the SVD segment, and its CAS adjustments, back to the correct 2330B payer.

In other words:

> SVD01 must uniquely identify the payer in that 2330B loop, so the system knows which payer those CAS adjustments belong to.

When the same value is used for multiple other payers, such as the same ID for both primary and secondary, our system cannot reliably separate which CAS adjustments belong to which payer, so the mapping does not display as expected.

### What Needs to Be Changed

To prevent this going forward, your source system should send distinct SVD01 values for each payer. A few approaches that typically work:

- Use clear labels:
  - SVD01 = PRIMARY for the primary payer
  - SVD01 = SECONDARY for the secondary payer
- Or use distinct IDs based on the payer code:
  - SVD01 = 00630A for the primary payer
  - SVD01 = 00630B for the secondary payer

The important part is that:

1. Each 2330B payer has its own unique identifier.
2. The SVD01 used in the payment and adjustment segments matches that identifier exactly for that payer.

Once those are unique and consistently matched, the CAS adjustments will map correctly in Claim.MD.