Fall 2009

New guidelines for BlueCard^®
Medicare crossover claims

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) recently streamlined its provider service procedures, decreasing hold times for BlueCard Medicare Crossover Claims. If the member has Medicare primary insurance and a Blue Cross and/or Blue Shield plan as secondary insurance, providers should first submit the claim to Medicare. Medicare will process the claim, then route the claim to the member's supplemental Blue Plan for processing. You will receive payment or processing information from the member's supplement plan after they receive proof of Medicare payment.

Follow these steps before calling BCBSF:

• Verify the Medicare Remittance Notice states “Claim information forwarded to: (Name of secondary payer).” which indicates the claim was forwarded for processing.
• If the claim did not crossover electronically, then submit the claim to BCBSF with the remittance notice attached (BCBSF, P.O. Box 1798, Jacksonville, FL 32231-0014).

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

• Please allow 45 days from the Medicare payment date for the secondary claim (Medicare supplemental coverage) to process.
• If calling about multiple claims, then sort them by the secondary payer for efficient processing.
• The total claim charge (not the balance owed) is required for research purposes.

Inquiries

Direct inquiries on secondary claims to BCBSF's Provider Contact Center at (800) 727-2227 unless the member's Blue Plan has 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.

BCBSF Resources

We have informational Medicare Crossover documents on our website, www.bcbsfl.com. Click Physicians & Providers, Tools & Resources, then Tips & Frequently Asked Questions.

• Medicare Crossover for Other Blue Plan Members (CMS-1500)
• Medicare Crossover for Other Blue Plan Members (UB-04)