MEDIGAP CLAIM-BASED CROSSOVER MOVES TO A CONSOLIDATED, STANDARDIZED PROCESS

This announcement is to inform you that the Centers for Medicare and Medicaid Services (CMS) will transfer the mandatory Medicare supplemental (MediGap) insurance claim-based crossover process from its Medicare contractors to the national Coordination of Benefits Contractor (COBC). 

For current information regarding this change: please visit the following web sites:

MLN Matters Related Change Request (CR) #: 5601 : Transitioning the Mandatory Medigap ("Claim-Based") Crossover Process to the Coordination of  Benefits Contractor (COBC) update 09/03/07

MLN Matters Related Change Request (CR) #: 5601: Clarification Concerning Provider Billing Procedures Related to the Transition of the Medigap claim-based Crossover Process to the Coordination of Benefits Contractor on October 1, 2007

            Coordination of Benefits Contractor site

NOTE: For your Medicare Crossover claims to be correctly forwarded to the secondary payor:  you will need to replace the OCNA/MediGap codes currently set up in your Utility/Insurance table with the new COBA codes.  Prime Clinical Systems, Inc can assist you with this task.  When you are ready to begin using the new COBA code: call our software support department, open a reference and ask us to update your codes.  Using a table provided by CMS with both the OCNA/MediGap codes and the COBA codes: PCS will run an SQL to replace the old code with the new.  If you do not have the OCNA/MediGap codes completed in your table: PCS will NOT be able to update your records to the new COBA codes.

For more information on registering Medicare patients who are MediGap, Supplement or have Medicare as Secondary Payor, please refer to the On-Line Documentation on Medicare Patient Registration.