Secondary Invoices
1. Secondary Invoice/Claim Generation
If a patient has a secondary funding source on file, the system will automatically generate a secondary CMS-1500 claim form to transition any remaining balance not covered by the primary funder.
The following amounts can transition to the secondary funder:
Not Covered
Copay
Deductible
Coinsurance
Other
Secondary invoices are stored under Billing Module → Posted Invoices, organized under the appropriate secondary funding source. To locate a specific secondary invoice, navigate to the Billing Module, select Posted Invoices, and filter or look for the secondary funder name to find the associated claims.
Identifying Patients with a Secondary Funder
When applying payments from a primary ERA, you'll notice a black S next to the primary funding type for patients who have a secondary funding source on file. This is your visual indicator that a secondary claim may need to be generated.
How to Trigger Secondary Claim Creation
Post the primary ERA/payment
Click Save & Post
Choose one:
Proceed to Clearinghouse → Creates AND submits the secondary claim directly to the clearinghouse. Note: This option is only available when the patient has a secondary funding source listed in their profile.
Proceed → Creates the secondary invoice internally (does NOT submit to the clearinghouse)
If the patient does not have a secondary funder, the remaining balance will automatically transfer to Patient Responsibility.
Patient Responsibility Invoices
When copay, deductible, or coinsurance amounts are applied on a claim and no secondary payor is configured in Motivity, the system will automatically create a new invoice for those amounts and transition the balance to patient responsibility. This patient responsibility invoice will be available under the Billing module and the Posted Invoices subtab. It is denoted by a red label that says “Patient Responsibility”.
2. Interest Payments
To apply an interest payment:
Select the manual payment, then the patient, then the date of service
Select the stacked change icon on the claim row
Set the Excess Type to Interest
Add any relevant notes and enter the amount
Select Save
Resetting Payment Values (Payment Adjustments)
Adjust Total Payment (Overpayments/Refunds)
In the event of an overpayment or if a refund is required, you can make adjustments by using the Adjust Payment icon, which appears as a red circular arrow. To access this icon:
Select the red pencil found on the right-most side of a payment
This will present a pop-up where you will see a red circular arrow
From here, payments can be refunded or offset to another payment to ensure funds are applied correctly.
Adjust Applied Payments (Fix Posting Errors)
If a payment was applied to the wrong claim or in the wrong amount, you can correct it:
Select the reset payment icon on the claim line (red circular arrow)
Revert the applied amount
The invoice reopens for correction
Note: Any associated secondary claims or patient responsibility invoices will be automatically voided when this adjustment is made. They can be regenerated after the correction is applied.
Denials & Resubmissions
What Is a Denial?
A denial occurs when a payer reviews a claim submitted by a provider and refuses to pay it, either in full or in part. You can identify a denied invoice by opening the black hamburger icon in Payment Posting and checking the noted status.
Automatic Denial Category Assignment
When a denial is received, the system automatically categorizes the claim and adds it to the Denials page. Denials that are not associated with Contractual Obligations, Deductibles, Co-Pays, or Co-Insurance will appear there for your team to review and take action.
Manually Assigning Denial Categories
After manually adding a payment, you can also assign denial categories to route claims to the Denials page. Denial codes can also be applied directly during manual payment posting by selecting the denial reason as listed on the EOB — when a denial category is selected, the claim is automatically transitioned to the Denials module worklist for follow-up.
To manually assign a denial category:
Manually add your payment
Open the gray payment line → green patient line → orange invoice line
Select the black pencil icon found under Denied +/-
Enter the Denial Amount, Denial Group, Denial Code, and Denial Category
Select the blue + icon
The denial record will now appear on the Denials page
Key Rule (Very Important)
Understanding the difference between these three options is critical before working denials:
Save and Post — Use when you have fully reconciled what the primary payer sent and are ready to pass the outstanding amount to the secondary payer or patient. Do NOT use this if you plan to resubmit a denied claim — it will pass the denied amount to the secondary payer.
Resubmit — Use when you have made corrections and need to send the claim back to the primary payer. This option does not post any payment amount to the system.
Save, Post & Resubmit — Use when you need to both post a payment amount and send a corrected claim back to the primary payer at the same time.
Before You Resubmit — Important Checklist
Before resubmitting a claim, make sure all necessary corrections have already been made. If the underlying issue hasn't been resolved, the claim will likely be denied again for the same reason. Updates to the following can be made in their respective modules within Motivity:
Contract
Patient benefit coverage
Authorization
Appointment details
Steps Resubmit a Claim
Step 1: Fix the Issue
Update any information that caused the denial before proceeding.
Step 2: Resubmit
Open the payment line in either the Denials or Payment Posting page.
Select the blue "Resubmit" button (or “Save, Post, & Resubmit” if you are also posting a payment while resubmitting)
If the payment came from an ERA, the Original Reference Number (ORN) will be entered automatically.
If the payment was entered manually, you'll need to enter the ORN yourself.
Choose one of the following options:
Generate, Edit, and Post — Generates the claim form, allows you to make edits, and posts it either internally or to a clearinghouse.
Post to Clearinghouse — Posts the invoice directly to your clearinghouse. This option is only available if you're integrated with a clearinghouse.
Post Internally — Posts the invoice internally to Motivity.
Cancel — Cancels the action.
Steps to Correct an Appointments After a Claim Has Been Billed
Step 1: Edit Appointment
Locate the claim in the Collections module and select the black pencil icon next to the Date of Service.
Select "Proceed," then choose the specific appointment you need to update.
Select the blue pencil icon to make your edits.
Select "Save" when you've completed your edits.
Step 2: Resubmit
Complete the Resubmission process as outlined above.
What Happens After Resubmission
The resubmitted claim will include:
Resubmission code 7
The original claim reference ID
If an ERA, the system will automatically pull this number. If a manual payment, it will need to be entered manually.
Track the resubmitted claim under Billing Module → Posted Invoices where it will display with a status of "Resubmitted." To help identify resubmitted claims, the system appends "RE" to the invoice number.
What do I do if: | Action |
Claim rejected by the Clearinghouse |
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Claim rejected by the payor |
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My claim denied as duplicate |
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My claim denied (for any other reason) | Contact the funder and work through the denial with them directly. |
Next Steps: Now that you have learned about secondary invoices, payment adjustments, and denials, understand when to reverse, regenerate, and/or resubmit a claim in our Motivity Billing 101: Reverse vs. Regenerate vs. Resubmit article.
Last Updated: 7/15/26 by Tatum Winslow