Crossover
Crossover is an automatic claim filing service used by Railroad Medicare
and Medicare Part B contractors to send claim information to your supplemental
insurance after Palmetto GBA has processed a Medicare claim for you. This saves
you the time of filing a claim with your supplemental insurer.
In order for you to be in the crossover program, you must enroll with your
supplemental insurer. Once you have enrolled, Railroad Medicare will receive,
on a regular basis from the supplemental insurer, a list of patients in the
crossover program. Once the lists are received from the crossover companies, claim
information is electronically compared with the list to determine if there is a
match.
If there is a match, the information is transferred to the requesting crossover
company. The information forwarded to the requesting company is similar to the
information provided on a Medicare Summary Notice (MSN). If your name and
Health Insurance Claim (HIC) number appear on the list, your claims processed
during that month will be forwarded to your supplemental insurer. You may be
enrolled in the crossover program with more than one supplemental insurer. You
can only enroll in the crossover program through your supplemental insurer, not
through Railroad Medicare. Likewise, if you want to stop the crossover program,
you must do this through your supplemental insurer.
The first claim submitted to Railroad Medicare will not cross over. This is
because your eligibility information must be added to Railroad Medicare's
system. As long as your name and HIC number appear on a company's monthly
crossover listing, Railroad Medicare will continue to forward claims
information to the supplemental insurer.
Some supplemental insurers do not offer crossover. You should contact your
insurance company to see if your policy is eligible for the crossover program.
Medicaid offers a crossover program with Medicare. The crossover list consists
of eligible Medicaid recipients. However, if you are on crossover with a
supplemental insurer, we will only forward information to the supplemental
insurer, not to Medicaid. In order for you to be on crossover with Medicaid,
you cannot be on crossover with any supplemental insurer. If you have both
Medicare and Medicaid, your health care providers must accept assignment on all
Medicare claims.
