When a patient has more than one source of coverage, a single claim can pass through multiple payers before it is fully resolved. This sequence (primary → secondary → tertiary → patient) and the associated Invoice(s) is handled differently in Brightree and NikoHealth.

In many Brightree environments, each Payer level (primary, secondary, tertiary, patient) is represented by a separate invoice ID. As responsibility moves from Payer to Payer, new Invoices are created and you need to keep track of which Invoice is the “real” one. This means tracking multiple Invoice IDs for the same service.

Brightree also adds unnecessary adjustments before the Payer even responds to the claim. This is triggered by the percentage of responsibility that the user assigns for each Payer in the sales order. This frequently leads to the user having to add additional adjustments instead of just applying the details exactly as they are remitted by the Payer.

In NikoHealth, there is one Invoice per Order. As you move through the Payer sequence, you update the responsibility on that invoice instead of creating a new one. The same Invoice record tells the whole story:

This provides a cleaner view of the claim lifecycle and simplifies reporting and follow-up.