5. Motivity Billing 101: Secondary Invoices, Adjustments, and Denials

Secondary Invoices

1. Secondary Invoice / Claim Creation

When a Secondary Funder Exists

If a patient has a secondary insurance on file, Motivity will:
- Automatically create a secondary claim (CMS-1500)
- Transfer remaining balances from the primary, including:
  - Not Covered
  - Copay
  - Deductible
  - Coinsurance

Secondary invoices are stored under:
- Billing Module → Posted Invoices (under secondary funder)

How to Trigger Secondary Claim Creation

Post the primary ERA/payment
Click Save & Post
Choose one:
- Proceed to Clearinghouse
  → Creates AND submits secondary claim
- Proceed
  → Creates secondary invoice only (does NOT submit)

Helpful Indicator

A black “S” icon next to the funding source = patient has secondary insurance

If NO Secondary Funder

Remaining balance automatically becomes:
→ Patient Responsibility

2. Interest Payments

How to Apply Interest

Select manual payment
Choose:
- Patient
- Date of Service
Click stacked change icon
Set:
- Excess Type = Interest
- Enter amount + notes
Click Save

Resetting Payments Value (Payment Adjustments)

Adjust Total Payment (Overpayments/Refunds)

Use Reset Payment icon (red circular arrow)
Options:
- Refund payment
- Offset against another payment

Adjust Applied Payments (Fix Posting Errors)

If payment applied incorrectly:
1. Select reset payment icon on claim line (red circular arrow)
2. Revert applied amount
3. Invoice reopens for correction

Important

Any related:
- Secondary claims
- Patient responsibility invoices
  → Will be automatically voided and must be recreated if needed

Denials & Resubmissions

Key Rule (Very Important)

Do NOT use “Save & Post” if you plan to resubmit a denied claim

This could send denied amounts to the secondary payer

Instead, use Resubmit

Steps to Correct & Resubmit a Claim

Step 1: Fix the Issue

Update as needed:

Contract
Patient coverage
Authorization
Appointment details

Step 2: Edit Appointment (if needed)

Go to Collections Module -> Payment Posting
Select black pencil icon next to Service Date
Select appointment → blue pencil icon → edit → save

Step 3: Resubmit

Select Resubmit (NOT Save & Post)
System will:
- Regenerate claim
- Submit to clearinghouse

What Happens After Resubmission

Claim includes:
- Resubmission code 7
- Original claim reference ID
- If an ERA, the system will automatically pull this number. If manual payment, it will need to be manually entered
Track under:
- Billing Module → Posted Invoices

What do I do if:	Action
Claim rejected by the Clearinghouse	Open the claim details and access the Timeline In the Timeline, look for Clearinghouse updates Review the status messages in order (top to bottom or most recent first) Look for the Clearing house rejection line Use this information to determine: What needs to be corrected (e.g., NPI, modifiers, formatting issues) Repost the claim by choosing the green Repost button > Regenerate (do NOT use Reverse)
Claim rejected by the payor	Review the Timeline to confirm it was rejected by the payor Contact the payor directly to obtain the rejection reason (if not available in the system) Identify what needs to be corrected based on payor feedback Make corrections (patient profile, contract, authorization, or appointment) Return to the claim Repost the claim by choosing the green Repost button > Regenerate (do NOT use Reverse)
My claim denied as duplicate	Go to the Billing module Select Posted Invoices or Denials Locate and open the claim denied as Duplicate Review the Timeline and denial details to confirm duplicate denial Check for duplicate appointments in the Scheduler Ensure the same service was not entered or billed more than once Review Contract configuration settings and verify aggregation rules are set up correctly Ensure services that should be grouped or separated are configured properly Confirm that the claim was billed correctly based on: Date of service CPT code(s) Units and providers If everything appears correct, contact the funder to determine why the claim was flagged as a duplicate Based on funder guidance: Make any necessary corrections, if applicable Or follow their instructions for reprocessing/review If corrections are needed, update the claim and follow above instructions to Resubmit the claim
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: Revierse vs. Regenerate vs. Resbumit article.

Last Updated: 4/22/26 by Kayla Lewis