How to Handle Secondary Insurance Authorization Approvals

Last updated: May 19, 2026

When a client has both primary and secondary insurance and the primary insurance does not cover ABA services, specific verification and authorization steps must be completed before billing secondary insurance.

Mission Control currently only syncs authorizations from the primary payer, since the primary insurance must be billed first before secondary coverage can be applied. If a secondary insurance approval is received, follow the steps below.

1. Verify Primary Insurance Eligibility

Before proceeding with secondary insurance billing or authorization:

  • Confirm primary insurance details using Silna (or the payer portal)

  • Submit an authorization request to determine whether ABA services are covered under the primary plan

  • Wait for a formal response from the primary insurance

2. Confirm Primary Insurance Denial

You may use secondary insurance only after receiving a primary insurance denial.

Acceptable denial reasons include:

  • ABA services not covered under the primary plan

  • Services not medically necessary per primary payer guidelines

Important: A valid denial must be on file before secondary billing can begin.

3. Check Secondary Insurance Benefits

Once primary denial is confirmed:

  • Verify secondary insurance benefits and eligibility

  • Submit an authorization request for secondary insurance coverage

4. Syncing Secondary Authorizations in Mission Control

If secondary insurance approval is received, you'll need to loop in the RCM team to manually sync the secondary authorization. They will review the primary denial and secondary approval to ensure the services will be covered before syncing.

Please note the primary insurance must be on file in MC. We will need to bill the primary insurance first and receive the denial before we can proceed with billing the secondary.

Please reach out to @support or @rcm with any additional questions or concerns!