Outsourced secondary insurance billing: who bills the second payer after the first one pays?
The primary paid. Somebody still has to bill the secondary.
A dedicated, full-time secondary billing specialist from Neon Link costs $2,995 a month, month to month, or $2,895 a month on the 6-month plan, with no setup fee. Working remotely from the Philippines or India on your US business hours, they pick up every claim once the primary payer has paid, check whether Medicare crossed it over to the supplement on its own, bill the secondary or tertiary payer with the primary's payment details when it did not, and fix the coordination of benefits problems that stall those claims. It fits practices and billing companies with many Medicare, Medigap, Medicaid or two-plan patients, while write-off and patient balance decisions stay with you.
Rates come from our live rate card. Page updated .
See 3 candidate profiles for your role
Tell us the role. Within 48 hours our team emails you 3 anonymized profiles from people who applied for this kind of work with us: their experience, their region and the software they use.
What your Linker handles
- Work the list of claims where the primary has paid and a secondary balance is still open, oldest and largest first
- Check whether Medicare crossed the claim over to the supplement or Medicaid automatically, and bill it directly only when it did not
- Bill the secondary or tertiary payer with the primary's payment, adjustment and denial codes, electronically or with the primary EOB attached
- Verify the order of benefits when a payer denies for coordination of benefits, and get the patient or the payer to update the record
- Follow Medicaid's payer of last resort rules, so Medicaid is billed only after every other plan has paid or denied
- Follow up on unpaid secondary claims by portal and phone, and correct and resubmit the ones that come back
- Move what is left to patient responsibility only after the secondary has paid or denied, by your rules
- Send the practice manager a short weekly note on secondary balances billed, paid, still open and why
We screen for the systems you run, such as Tebra (Kareo), AdvancedMD, eClinicalWorks, athenahealth, WebPT, NextGen or Epic, and the clearinghouses and payer portals your claims go through, such as Availity, Office Ally or Waystar. If a finalist has not used yours, you'll know before they start.
How the work is measured
What your Linker is measured on. The targets are set with you in the first week, from your volumes and your hours, and written into your statement of work.
- Every claim with a paid primary and an open secondary balance picked up on the cadence you set
- No balance moved to the patient while a secondary or tertiary payer still owes
- Every coordination of benefits denial worked to a corrected record and a resubmitted claim, or escalated with the facts
- Every payer call logged with a reference number, a name and a date
What a team costs
| Team | Month to month | 6-month plan |
|---|---|---|
| 1 Linker | $2,995 | $2,895 |
| 2 Linkers | $5,990 | $5,790 |
| 3 Linkers | $8,985 | $8,685 |
| 4 Linkers | $11,980 | $11,580 |
| 5 Linkers | $14,975 | $14,475 |
| 6 Linkers | $17,970 | $17,370 |
Per month. 40 hours a week per Linker. No setup fee. Prices from our live rate card.
How we vet your Linker
Our recruiting team in the Philippines runs a strict screening and review of every applicant, using a process built by our founder, Dan Betthauser, from twenty years running outsourced operations across the Philippines, Costa Rica and the United States. Every Linker goes through:
- A screen of the application against your role: the work, the software and the experience you need
- A recorded spoken English sample, reviewed by our team
- A practical skills test for your work, scored in our own system
- A live video interview with our recruiting team
- An ID check and a background check: NBI clearance in the Philippines, police clearance in India and Pakistan
- A workspace check before day one: a quiet, private room, wired internet, a backup connection and a plan for power outages
- A signed confidentiality agreement before they see any of your data
- Your own interview with the finalist: nobody starts until you say yes
How it starts
- Step 1Tell us the work: a 15 or 30 minute call with our team, or the sixty second scope on the homepage.
- Step 2Get a written quote at the published rate, held for 30 days.
- Step 3We recruit and screen for your work and your software, and you interview the finalist before they start.
- Step 4Your Linker works your queue on your hours. A Neon Link manager runs the account and answers when you need them.
- Step 5If the fit is wrong in the first 60 days, we swap them at no cost.
A good fit, and not a fit
- Practices with many Medicare patients who carry a supplement, such as physical therapy, cardiology, ophthalmology or primary care
- Billing companies whose secondary balances sit in aging because the team works primaries first
- Practices that see patients covered by two commercial plans, such as children on both parents' plans
- Deciding write-offs, small balance adjustments or when a balance goes to collections. Your Linker brings the account; you decide
- Coding or changing a claim's codes. That stays with your coder
- Practices whose state Medicaid program or payer contracts do not allow patient data to be handled offshore. Check yours before you start
Open roles behind this page
We recruit for this work now. These are the live postings we hire your Linker from:
See 3 candidate profiles for your role
Tell us the role. Within 48 hours our team emails you 3 anonymized profiles from people who applied for this kind of work with us: their experience, their region and the software they use.
Questions owners ask
How much does it cost to outsource secondary insurance billing?
$2,995 a month for one dedicated, full-time person (40 hours a week), month to month, or $2,895 a month on the 6-month plan. There is no setup fee, and pay, equipment and management are inside that one number. For comparison, a US medical records specialist costs about $5,990 a month fully loaded, using the BLS median wage plus employer costs.
Why do secondary claims get stuck?
Most stall for a few plain reasons: the claim did not cross over from Medicare when everyone assumed it would, the secondary payer was never sent the primary's payment details, the order of benefits on file is wrong, or the team worked primary denials first and the secondary balance aged out of sight. One person whose job is the secondary list catches all four.
Do they check Medicare crossovers?
Yes. When Medicare pays, it forwards many claims to the supplement or to Medicaid on its own. Your Linker checks the remittance for the crossover, waits for the supplement to pay when it crossed, and bills the supplement directly when it did not, so a claim is never billed twice or not at all.
How is patient information handled?
HIPAA requires a business associate agreement before an outside party handles patient information, so one is signed before your Linker sees any. Your Linker signs a confidentiality agreement, passes a background check, and works from a private space where patient information cannot be seen or overheard. We screen for people who understand the HIPAA minimum necessary rule and keep patient records off personal devices, and they work inside your systems with the access you give them. Some state Medicaid programs and payer contracts limit offshore access to patient data, so check yours before you start.
How is this different from hiring a virtual assistant?
You get one dedicated person who handles your work on your hours, inside your software, and a Neon Link manager runs the account: pay, equipment, replacement if it comes to that, and a phone that gets answered. You never run offshore payroll or manage a freelancer alone. It is not a ticket queue or a 24/7 answering line.
How fast can someone start?
We start recruiting when you say go. You interview the finalist before anyone starts, and the start date is set with you once you pick the person. We would rather take the time to find the right fit than hand you whoever is free.
What if the person is not the right fit?
If the fit is wrong in the first 60 days, we swap them at no cost. After that, if they leave, we recruit the replacement at no charge and manage the handover. Training on your process runs at the normal monthly rate.
Do we have to sign a long contract?
No. Month to month is available on every plan. The 6-month plan trades a longer commitment for a lower monthly rate. A written quote at the published rate is held for 30 days.
Related pages
- Medical Billing Companies: Claims follow-up, AR and denials, payer enrollment, the queues your team never gets to.
- Underpayment recovery specialist: What a dedicated specialist costs to find payer underpayments against your contracted rates and work them back, for a flat monthly price instead of a share of what comes back.
- Credit balance and refund specialist: What a dedicated specialist costs to work your credit balance report, fix posting errors and prepare patient and payer refunds for your approval.
1 US medical records specialist, fully loaded: ~$5,990/mo How we calculate this
Or describe your week
and watch your team draft itself.
The sixty second scope on our homepage reads what is drowning you and drafts your team, the first moves, and the number.
Try the sixty second scope