The Medicare crossover process routes Medicare Supplemental claims straight from Medicare to the insurance provider. This eliminates the need for medical providers to send the claim to the insurance company as well, lessening the hassle for the medical office staff and avoiding dual submissions of the same claim, notes BlueCross BlueShield of Illinois.Continue Reading
When both doctors' offices and Medicare sent the same claim to insurance companies, this led to confusion and inaccuracy in the payment process. The resulting delays and underpayments led to frustration among patients and medical professionals alike. Patients often ended up receiving bills for medical expenses that the insurers didn't cover. The lack of coverage was found to be an error because the Medicare benefits covered the full expense, but the fact that the doctors' offices submitted the claim before Medicare did caused the insurance company to bill the patient erroneously, as stated by BCBSIL.
There are some doctors' offices that continue to submit claims rather than allowing the Medicare crossover process to take place. Insurers have instituted new rules to minimize these errors, such as requiring medical providers to wait a full month after the initial remittance date from Medicare before they submit that same medical claim to the insurance company for payment, according to BCBSIL.Learn more about Health Insurance