Filing the Medicare Cross-Over Claim

File the claim to your Medicare carrier for primary payment. Claim information will not be crossed over to the member’s supplement plan (the secondary payer) until after Medicare has processed the claim and released it from the Medicare payment hold. Medicare secondary claims will normally be electronically forwarded by GHI (the CMS vendor) directly to the member’s supplement Blue Plan for processing of the secondary benefits. Check the Medicare Remittance Notice to identify whether the claim was crossed over directly to the member’s Medicare supplement Blue Plan. If it did, you do not need to take further action. The paper remittance notice will state “Claim information forwarded to: (Name of secondary payer). “ The 835 (electronic remittance) record can also carry the secondary forwarding information.

You will receive payment or processing information from the member’s supplement plan after they receive the Medicare payment. Please allow 45 days from the Medicare payment date for the secondary claim (Medicare Supplement coverage) to process.

If the claim did not crossover electronically to the secondary payer (Medicare supplement plan), then file the claim to BCBSF with the Medicare Remittance Notice attached. Send the claim to:

Florida Blue P.O. Box 1798 Jacksonville, Florida 32231-0014

Do not send secondary claims directly to the member’s Blue Plan secondary payer.

Note: If more than one claim appears on the Medicare Remittance Notice, please indicate the specific claim you are filing.



Inquiries around Medicare Crossover Claims

Direct inquiries on secondary claims to Florida Blue unless the member’s Blue Plan have requested specific information from you on a particular claim. Inquiries received on secondary claims by BCBSF will be coordinated with the member’s Blue Plan for resolution.

Example: A provider received the primary Medicare payment. The Medicare Remittance Notice stated, “Claims information was forwarded to: (Name of secondary payer).” It has been 45 days since Medicare’s payment and no communication has been received from the member’s supplement plan. This should be sent to Florida Blue as an inquiry so the member’s Blue Plan can be contacted and a resolution made on the status of the secondary claim. Florida Blue will communicate the resolution back to the provider. 13