Medigap insurance and Medicare cross over claims

A Medigap policy is an individual health benefit plan offered by a private insurance company to supplement Medicare. It provides reimbursement for charges not payable because of deductible, coinsurance or other limitations. For participating providers, Medicare will send payment information directly to Medigap insurers if the appropriate information is provided on the 1500 claim form.

There 12 different Medigap policies are available from A to L. Each policy has their own rules and benefits. Check the benefits of Patient Medigap policy before submitting the claims. Patient has to pay separate
premium for this insurance also.

Medicaid is not a Medigap. Know More and also check the below links.

What is Medigap and what does it covers

Crossover insurance companies are insurers that provide secondary insurance plans and participate in the crossover program. Claims are automatically crossed over (for both participating and non-participating providers) when eligibility information is forwarded to Medicare from the plans that participate. There is nothing you need to indicate on the claim form. The Provider Remittance Notice will show a message that will tell you that the claim information has been forwarded to the secondary insurer.

The big advantage is we don't need to send the secondary claims.

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