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PAP201

Medicare Part B Crossover Claims


Provider Administrative Policy

Section
Blue Cross of Idaho Information
Policy Date
February 2008
Status/Date
Revised/October 2013
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts


Policy

Medicare Part B Crossover Claims

The Center for Medicare and Medicaid Services (CMS) has expanded Medicare Part B claims crossover to include Medicare supplements and coordination of benefits (COB) claims. (Exception: critical access/rural health for physical therapy see PAP350 ).

Electronic and printable COB questionnaires are available online via the secure provider portal.  To locate the questionnaire, visit the Blue Cross of Idaho web site at bcidaho.com and:

  1. Select Medical Provider
  2. Log on
  3. Select Forms on left navigation
  4. Select Coordination of Benefits Tool on left navigation
  5. Select the online form and complete the patient`s secondary information
  6. Use the fax transmittal form to fax a copy of the secondary insurance card. 
  7. If "no other insurance" stated, enter "none" in the Name of Insurance Plan field
  8. Enter "patient states no other insurance" in the Comments field. 

Complete the form and print the fax transmittal form and fax to Blue Cross of Idaho with a copy of the member card. 

Do not send a duplicate hard copy or electronic claim to Blue Cross of Idaho for processing when Medicare has noted our claim has crossed over. (See PAP402)

Use the secure provider portal to check claim status. If your claim`s crossover does not take place within 30 days of the Medicare's process date; submit an inquiry via the Blue Cross of Idaho website to Customer Service for Commercial business, or contact FEP Customer Service directly for Federal Employee Program claims. We will update the files so future claims will crossover from Medicare.

This policy does not apply to the Department of Veteran Affairs (VA).

For assistance, contact our Provider Contact Center from 8 a.m. to 5 p.m. MT, Monday, Tuesday, Thursday and Friday, or 8:30 a.m. to 5 p.m. MT, Wednesday. (See PAP100 )


Policy History

Date Action Reason
October 2013 Revised Updated to reflect it does not apply to the Department of Veteran Affairs.
September 2013 Revised Updated website instructions.
June 2012 Revised Removed reference to MA CS Dept. Renamed Commercial and FEP CS to Provider Contact Center
July 2009 Revised Customer service hours revised
November 2008 Revised Language clarification/contact links
August 2008 Revised Language clarification
May 2008 Revised COB questionnaire information added

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