What’s New This Week

Medicare Claims Support for Primary and Secondary Insurance

Organizations billing Medicare can now manage Primary and Secondary insurance workflows more reliably, including support for coordination of benefits (COB).

You can now:

• Submit claims with both Primary (Medicare) and Secondary insurance in one workflow
• Confirm whether payer information is complete before submitting
• Submit a secondary claim manually after receiving remittance, if needed

This supports both:

• Automated coordination of benefits (COB)
• Manual secondary billing when coordination does not occur

FHIR Patient Search by External Identifier

External systems can now search for members using their own patient IDs through the FHIR API.

Key updates:

• External identifiers from partner systems are automatically stored and mapped to members
• A new FHIR Patient search supports queries using {system, value} identifiers
• Admins can view all external identifiers directly on the member profile

This improves interoperability and makes it easier to connect Pear Suite with external systems without manual ID matching.

Improved Claim Processing and Reliability

We’ve rebuilt how payer files are processed behind the scenes to improve reliability and scalability.

What this means for you:

• Claim updates from payers are more consistent
• Duplicate processing is eliminated
• System performance is more stable as volume increases

No changes are required—this improvement happens automatically.

View Full Claim Acknowledgement History

Claims now include a complete history of all payer responses, not just the most recent one.

You’ll now see:

• A new “Claim Acknowledgements” section on the claim details page
• Every acknowledgement tied to the claim, including multiple payer responses
• Key details like payer, charge amount, and paid amount
• Ability to download acknowledgement files directly

This makes it much easier to understand how a claim progressed across payers.

Drag and Drop Reordering for Templates

You can now drag and drop to reorder items when building templates.

Supported areas:

• Question answer options
• Data point template options
• Goal template action items

Changes save instantly, and existing data remains unchanged—no need to delete and recreate items just to fix the order.