August 2009
Medicare crossover claims for new products
We are now receiving Medicare crossover claims electronically for Regence Innova, Engage,
Activate and HSA Healthplan 2.0 members. When Medicare processes a claim, the information is transferred to Regence directly. This allows us to receive and process the claim under the secondary coverage, saving you time and eliminating the need for you to submit a separate claim.
If the indicator on the Explanation of Medical Benefits (EOMB) or payment advice from Medicare shows the claim automatically crossed over (claim status code 19: "Medicare paid primary and the Intermediary sent the claim to another insurer"), you do not need to submit the claim for processing on the member's secondary coverage.
If the indicator on the EOMB or payment advice does not indicate the claim crossed over, submit the claim along with the Medicare payment advice.