Who this is for: Billing and RCM staff who create and submit insurance claims in Barti.
Before you start, you'll need:
The patient's Primary Insurance and Secondary Insurance added to their record
An invoice for the encounter you're billing
1. Create the insurance claim
From the patient's invoice, click Create an Insurance Claim.
2. Confirm the primary and secondary insurance
The claim uses the patient's Primary Insurance and Secondary Insurance.
Check that the correct payer is listed as primary and the correct payer is listed as secondary.
Primary and Secondary insurance cannot be the same — Barti blocks the claim if both fields match.
3. Submit the claim
Click Submit Claim to send the claim to the clearinghouse.
❗ Important: How many claims you submit depends on the payer mix. If the primary is Medicare, this one submission is all you need — Medicare crosses the balance over to the secondary payer. If both payers are commercial (non-Medicare), you'll file a second claim to the secondary payer after the primary pays.
What you'll see when it works
The claim moves out of draft and into a submitted status. As payers respond, payments post to the invoice labeled Payment (Primary Insurance) or Payment (Secondary Insurance), and any remaining balance appears on the Insurance Aging Report under the payer that currently owes it.
Related articles
Insurance Aging Report
Creating an insurance claim
Adding a patient's insurance
If you have any questions, please refer to Barti's Help Center or create a support ticket at support.barti.com.
Frequently asked questions
Do I create two claims for secondary insurance, or just list a primary and secondary on one claim?
It depends on the primary payer. When the primary is Medicare, file one claim with both the primary and secondary insurance listed — Medicare forwards the remaining balance to the secondary payer, so a second submission isn't required. When both payers are commercial (non-Medicare), submit the claims separately — file the primary claim first, then file a second claim to the secondary payer after the primary adjudicates.
Why is there a secondary insurance field on the claim if I sometimes have to create two claims?
Listing the secondary insurance records the coordination of benefits (COB) on the claim. For a Medicare primary, that secondary listing is what lets Medicare cross the balance over automatically. For two commercial payers, the secondary listing carries the COB information, but you still file a separate secondary claim once the primary has paid.
How does the Insurance Aging Report work for a Medicare-plus-secondary claim — does it only show as a Medicare balance?
The balance shows under the primary payer (Medicare) until Medicare pays. Once Medicare adjudicates, the remaining balance transitions to the secondary payer on the report.
If a Medicare claim has two lines and one line is paid while the other is rejected, does the balance transfer to the secondary?
Yes — the remaining balance transfers to the secondary payer, even when only some lines on the claim were paid and others were rejected.
Is this the same as other billing vendors?
Yes — Barti's handling of Medicare crossover and secondary claims follows the same approach as other RCM/clearinghouse vendors.