FAQ: Primary and Secondary: Accounts vs. Insurance
- Dylan Nigh
MacPractice uses the language of Primary and Secondary on an account level, which has a tendency to become confusing for those who are already comfortable with the language of Primary and Secondary in terms of medical billing. This article is written with the intention of helping differentiate between the two.
Every new account in MacPractice has a Primary person and an optional Secondary Person. The Primary of the account can be the same as the patient, if there is only one person on the account. That Primary can also be the head of household, or in most common instances the insurance guarantor for the patients on the account. The Primary person on the account may also not hold the insurance for the patient, but rather is a guardian. A child with Medicare may be their own guarantor, but that does not mean we want them to be the Primary Account holder. Their guardian would be set as a Primary Account holder, and the child could then be added to the Secondary Patient tab and input their Primary insurance.
A patient may have more than one insurance policy needed to bill for procedures. It's not the intention to use the Primary Account tab for only Primary insurance, and the Secondary Account tab for Secondary insurance.
Rather, if the policyholder for both primary and secondary insurances is the same person, both of those insurances can be listed under whichever tab (Primary or Secondary) that policyholder is listed. Adding an insurance reference to the Primary person on the account does not mean it has to be the Primary Insurance for the patient.
An example:
10 Year old Bobby's parents are divorced. He lives with Mom, but both parents have policies that cover their child. Dad hold's the primary insurance, whereas Mom has the secondary insurance coverage for Bobby.
Because Bobby lives with his mom, it makes more sense to have the mother be the Primary Account holder. The father is also a policy holder, so we can put him on the secondary tab for the account. We can then add each respective insurance for the policy holder. To ensure the dual insurances for the patient are arranged in a proper order, we'll want to go to the Patient's Insurance tab and then sort them in the proper order.
