DecisionHealth, DecisionHealth - 2006 Issue 5 (May)
Make sure secondary payments don't fall into a black hole
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Article Overview
This article discusses Medicare claims that are automatically crossed over to secondary payers such as Medicaid and supplemental insurers, and why practices should monitor them closely. It is aimed at billing and revenue cycle staff who handle remittance review, claim follow-up, and accounts receivable management. The article covers general workflow considerations, payer follow-up, and remittance advice indicators that signal a claim has been forwarded to another payer.
Why This Topic Matters
Secondary claims can appear to move through the system but still fail to result in payment, creating avoidable delays and revenue loss. The article helps practices understand where crossover breakdowns may occur and why tracking these claims is important for protecting cash flow.
What You Will Learn
- How automatic crossover claims to secondary payers are handled in a general sense
- Why remittance advice should be reviewed when Medicare forwards a claim
- How billing staff can track unpaid secondary claims
- What follow-up steps practices may take when a secondary payer does not respond
- Why training staff to recognize unresolved crossover claims matters
Who Should Read This
- Medical billing staff
- Revenue cycle managers
- Practice administrators
- Accounts receivable staff
- Coding and reimbursement professionals
Codes Discussed
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