The Connection OnlineSM

April 2011

April 2011

Medicare crossover reminders

In situations where Medicare is the member's primary coverage, such as those on Regence Bridge products, please remember to submit claims to your local Medicare contractor first. When the contractor processes a claim, the information is transferred directly to Regence. This allows us to receive and process the claim under the secondary coverage, eliminating the need for you to submit a separate claim.

If the indicator on the Explanation of Medical Benefits (EOMB) or payment advice from Medicare shows the claim automatically crossed over (claim status code 19: "Medicare paid primary and the Intermediary sent the claim to another insurer"), do not submit the claim for processing on the member's secondary coverage. Please allow adequate time for us to process your secondary claims. If needed, you can check claim status in the Provider Center.

If the indicator on the EOMB or payment advice does not indicate the claim crossed over, please submit the claim to Regence, along with the Medicare payment advice to receive payment. If you are submitting the claim electronically, please follow the process for submitting supporting documentation to attach the EOMB.

Learn more about Medicare crossover on our Provider Web Site.

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