For non-crossover claims, the additional claim for the secondary payer should be sent with a copy of which document?

For non-crossover claims, the additional claim for the secondary payer should be sent with a copy of which document?

• A. Explanation of benefits
• B. Remittance advice
• C. Notice of denial
• D. EOB

Answer: (B)

When a secondary payer is involved for non-crossover claims, you need to show exactly how the primary payer treated the claim so the secondary can determine what remains payable. The remittance advice is the document that provides that detailed adjudication information from the primary payer. It explains what the primary paid, the allowed amount, any patient responsibility, adjustments, and any denials. Attaching this to the secondary claim gives the secondary payer the precise context they need to process the claim correctly and coordinate benefits. While an Explanation of Benefits can convey similar details to the patient, the remittance advice is the formal payer-to-provider record used specifically for secondary submissions. A Notice of Denial only shows a denial, not the full payment history, so it doesn’t serve the same purpose.

When a secondary payer is involved for non-crossover claims, you need to show exactly how the primary payer treated the claim so the secondary can determine what remains payable. The remittance advice is the document that provides that detailed adjudication information from the primary payer. It explains what the primary paid, the allowed amount, any patient responsibility, adjustments, and any denials. Attaching this to the secondary claim gives the secondary payer the precise context they need to process the claim correctly and coordinate benefits. While an Explanation of Benefits can convey similar details to the patient, the remittance advice is the formal payer-to-provider record used specifically for secondary submissions. A Notice of Denial only shows a denial, not the full payment history, so it doesn’t serve the same purpose.