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When we first started our medical billing business in 1994 I had no previous experience at billing any medical claims, let alone secondary and tertiary. (You mean some people have 3 insurances?) I knew nothing. In fourteen years of billing I've learned quite a bit and I see from questions in our forum that many beginners do not understand secondary and tertiary claims billing at all.

First of all, how does anyone get two or three policies and which is determined primary? If a husband and a wife both work (who doesn't?) and they are both covered by health insurance by their employers, they may both have family policies so they are both covered under each others plan. One would be primary and the other secondary. Now if one of this couple (a few years ago we would have assumed that it would only be the husband) had previous military experience and carried over their Tricare military insurance, that would be the third payor (if there was a balance left).

Which company is primary and which one is secondary is determined by one of a couple different methods. First of all, if a person is working and they carry insurance, that insurance is primary (unless they have Medicare and their employer has less than 100 employees). If a person is retired and has Medicare but the spouse works and carries a family policy, then the spouse's plan would be primary and the Medicare would be secondary.

There is no way to cover every scenario but basically whether or not the person or the spouse is working can determine the order. For dependents (usually children) some go by the "birthday rule" meaning that whichever parents birthday falls first in the year is primary. Of course with all of the divorce out there sometimes the order of insurance is determined by a court order.

When a patient is seen by a provider the claim is sent on a CMS 1500 form to the primary insurance carrier either electronically or on paper. Electronically it can be sent either directly to the insurance carrier by special software or through a service or through a clearing house. When sent on paper it simple means the claim is printed to a paper CMS 1500 form and sent through the mail. Whatever the case is, it is important that you know the order of the policies.

Once the primary insurance carrier pays their share of the claim it is then submitted to the secondary insurance company if the patient has one. Secondary claims can also be sent electronically and on paper. Medicare is mandating electronic submissions even on secondary claims. When submitted electronically all the information from the eob (explanation of benefits) is entered into the claim information and submitted to the secondary insurance carrier.

When the secondary is submitted on paper, the claim is printed out again on a cms form and a photocopy of the eob is attached. If other patients are listed on the eob, their personal information should be hidden. Many offices use black markers (we call them smelly pens) to draw through the unwanted information. I've set up a bunch of various width strips of white cardboard that we slide into clear report covers to cover the unwanted information before we photocopy. We only do this with companies that are not yet accepting electronic submissions.

If there is still a balance after the secondary insurance carrier pays their share, the claim is sent on to the third carrier. It is printed out again on a cms form and copies of the eobs of both the primary and the secondary insurance carriers are attached.

Whenever you send secondary and tertiary claims on paper, make sure the photocopies you attach are clear, easy to read, and for the correct date of service. Many insurance carriers scan the eobs which lightens them a little. If the copy you submitted was already light, by the time the claim is processed it may be sent back to you as unreadable. It takes a lot more time to find the original eob and resubmit a claim than it does to get it right the first time.

Secondary and tertiary claims can sometimes seem like a pain to get paid - especially because they can be for a very small amount of money. It is still important to file and track these claims to keep your receivables under control. It may not seem like a lot of money but it adds up. If you have a system for submitting them it really isn't that bad.

Alice Scott and her daughter / partner Michele Redmond are co-owners of a medical billing service. They offer an informational website for anyone looking for information or help with their problems with medical insurance billing. Here are more articles on submitting insurance claims. You can also sign up for their free monthly newsletter or join their free medical billing forum to get answers to your billing questions.

A Mix of Style and Function: Nokia 6700 Slide

Nokia knows how to please the crowd, and when this budget-type 3G phone finally hits the shelves, you know they at least made sure that the device looks the part of being everyone’s 3G phone.

With six rich colors to choose from, a distinctively stylish aluminum body and practical 3G functions, the Nokia 6700 Slide is a testament to the fact that 3G will truly be the next standard in mobile devices.

Style

Form is the primary asset of the 6700 Slide, and as you may have guessed from the name, this is a slider. On a bit of an odd note, when the keypad is fully slid out, the Slide looks conspicuously a lot like the BL20 Chocolate. While the Chocolate is a little more edgy and uses a lot of lines for form, the Slide is more about subtle curves and rounded edges.

The consistent black slide out keypad is a flat surface with neatly arranged buttons that give the phone that feeling of sophistication. The screen flows smoothly into the black round edged boarder giving the slide a poised composition. Overall, this 6700 slide is an impressive piece of work that should make any owner visually satisfied.

Hardware and Capabilities

The Nokia 6700 Slide features a 2.2 inch TFT screen with a display capacity of 16 million colors and has a resolution of 240 x 320 pixels. It’s bright and nicely sized; the resolution also ensures that the font size of texts is easy to read.

The entire slide phone is relatively small, at 95.2 x 46.1 x 15.9 mm, the phone can be easily slipped into a bag or pocket. Also, it only weighs a total of 110g (just a wee bit lighter than the 6700 classic), so do not worry about this slide phone being too cumbersome when travelling.

The power source of this phone is an 860 mAh Lithium-Ion battery; this provides enough power to keep the device running on standby for up to 300 hours on 3G and 250 hours on 2G. At full charge, the talk time for 2G can reach up to four hours while it reaches 3 hours on 3G. Continuous music playback is good for a full 29 hours.

The 5 mega pixel camera uses Carl Zeiss lenses, giving you a clear, more detailed picture. It also has auto focus and LED flash features. This will make night and indoor shooting much easier; also, the autofocus helps a lot when there are plenty of background details.

Slide Not for Sale, Yet

Right now, no carriers or retailers are announcing that they will have the device available. For those who are interested for a device with almost the exact same specifications as the Slide but can do without the slide-phone design, the Nokia 6700 classic is readily available. The candy bar predecessor of the Slide is available on various pay monthly plans from O2, Vodafone, and Orange Mobile UK. For those who really want a Slider phone, all that can be done is to wait until the device gets a definite launch date next year. The estimate retail price for the device is at 160 Euro.

About the Author

You can visit Best Mobile Contracts to see all the latest mobile deals available. You can compare all the best deals for the Nokia 6700 Slide. You can also find the best deals for many other Nokia phones.

How can I unlock my T-Mobile Sidekick Slide? ?

Any code I can use to unlock my phone so I can use it with other carriers?

All SIM unlock codes are tied to the particular device IMEI and are carrier specific. The request for that code would need to be made from the carrier that the phone was originally manufactured for. Each carrier has their own guidelines as far as what requirements have to be met before that code will be given out. This is a free process. The only other carrier that uses GSM in the US is AT&T

Carrier fees up 42% to $7.8 billion
The Department of Transportation said airline revenue from so-called ancillary fees rose 42 percent to $7.8 billion in 2009. The biggest chunk of that came from checked-baggage fees, which were introduced in 2008 when oil prices soared and eventually reached $147 a barrel.

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