Medicare now does a much better job of crossing claims over to the secondary payors than in the past. Rarely anymore do I have to copy the Medicare EOB, print a HCFA and send it to the secondary. Still, the biggest headaches are the claims that are denied for no good reason, like the guy who has to have his cerumen removed every 8 weeks or so or he can't hear and Medicare says that it won't pay because it deemed the procedure unnecessary. Those you have to call on and that's where a lot of time is spent. I have a retired biller come in one day a week to handle those annoyances, probably could get by with once every two weeks, but she also does all the scanning of the mail.
You still need some kind of PM program that does the accounting and reporting. I am using the same one I have used for almost 15 years but, if I were looking to start new, I would look closely at Practice Mate.
