Crossover Agreement Medicare


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Claims are automatically passed to the secondary blue plane. Effective January 1, 2008, Medicare will process claims on all blue service plans covered by Medigap and Medicare Supplemental. This leads to the automatic submission of Medicare claims to Blue Plan`s second payer and reduces or eliminates the need for the provider`s office or billing department to submit an additional claim to the secondary carrier. Blue Cross and Blue Shield Plans use the centers for Medicare and Medicaid Services (CMS) cross-process to obtain Medicare primary claims. The CMS crossover process directly transmits Medicare Supplemental Claims (Medigap and Medicare Supplemental) from Medicare to Blue Cross and Blue Shield of Texas (BCBSTX). How do I submit an application if Medicare is primary and blue plan secondary? What should I do in the meantime? If you filed the application with the Medicare intermediary and did not receive a response to your initial request, do not automatically submit another request. Who should I contact when I have questions? If you have any questions, please call BCBSTX at 1-800-451-0287. Claims filed with Medicare are moved to the Blue Plan after being processed through Medicare. If the Home Plan gets a Medicare primary entitlement before it is exceeded, it can be poorly paid based on an estimated Medicare benefit statement (EOMB). . If you receive Medicare`s transfer advice, you will find out if the claim was automatically forwarded (thwarted) to the Blue Plan: After the claim is presented to the Medicare sponsor: Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information to healthcare professionals.

Availity provides administrative services for Blue Cross and Blue Shield of Texas (BCBSTX). BCBSTX does not give endorsements, assurances or warranties regarding products or services offered by independent third party providers such as Availity. If you have any questions about the products or services offered by these suppliers, please contact the supplier(s) directly When should I expect payment? Claims you submit through Medicare will only be transferred to Plan Bleu once they have been processed through Medicare. This process can take up to 14 business days. This means that the Medicare intermediary releases the right to the Blue Plan for treatment at about the same time you receive the Medicare transfer advice. As a result, it may take you another 14-30 business days to receive payment for the Blue Plan….