General Category > General Questions

Crossover claim

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RichardP:

--- Quote from: carflorida on March 14, 2013, 02:09:12 PM ---So the healthcare provider is not responsible for setting up the crossover? It is the patent's?
--- End quote ---

Yes.

Michele:
On the verification, yes, unfortunately do to spammers.

K and K Billing:
I will disagree that the beneficiary has to set up the crossover with Medicare in all cases - AARP will do that when a person signs up for the AARP Medicare supplement plan. (Personal experience) There may be others that do it also. In NY and CT, the local Medicare contractor has an IVR that will tell you if there is an automatic crossover. They also have a web site to give that information as well as other information.

If a claim is not crossed over then you have to file a paper claim (most cases) with the secondary and include a copy of the primary EOB. You can use the original claim to Medicare, but have to switch the primary and secondary insurers and put the paid amount by Medicare in field 29 of the 1500 form.

PMRNC:
BOTTOM line is that because of privacy laws.. the beneficiary is ultimately responsible for setup of the cross over.

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