Contingent Secondary Payer (CSP) claims
Path: Claims > Process > Process a Cycle
Require payment or denial from other payers prior to submission to the CSP payer. A CSP claim is calculated using either the billing rates defined for the payer or the rates of the previous payer.
The CSP claim is not generated for claim processing until:
- The prior claim (primary or secondary) is closed.
- The balance on that claim is zero.
- CSP adjustment to that claim have been made.
When a CSP claim is released, the payments (or adjustments, based on the adjustment type) posted to the prior payer or payers are deducted from the claim when calculating the gross and net charges for the claim.
The CSP claim uses either the payments from the prior payers or a combination of payments and special adjustments to determine what should be subtracted from the claim and to calculate the due amount for the CSP payer. This setting is controlled in the CSP Billing Rules field in Administration > Financial > Insurance Codes > General.
Associated pages
- About Claims
- Claim types
- Claim statuses
- Claim cycles
- Eligible CSP Payers
- CSP claims for primary PPS payers
- CSP claims chain for primary PPS payer
- Recalculation of CSP claims if primary payer is PPS
- Claims corrections
- Claims financial corrections
- Claims demographic corrections
- Void and replacement billing
- Demand billing
- Change billing cycle end date
- Process corrections cycles
- Force correction of claims
- Print claims