Medicare Crossover 5010 Issue

November 28, 2012

Medicare Crossover 5010 Issue If you are experiencing a high volume of claims not crossing over from Medicare, it may be because Medicare uses information stored within its internal provider or supplier files for Coordination of Benefits (COB)/Medicare claims crossover purposes. Specifically, the Medicare claims processing systems use the on-file physical or practice address information when creating the required Bill-to Provider (2010AA) name and address elements on Outbound Medicare Coordination of Benefits (COB) Claims. This will happen even when the original claim has the correct street address in the required Bill-to Provider (2010AA) name and address elements. Please refer to MLN Matters Number SE1245 located at http://inet,state.me.us/dhhs/oms/index.html.

If you think this may be affecting your Medicare crossover claims, you should contact your local jurisdictional Fiscal Intermediary (FI), carrier, DME MAC, or A/B MAC to confirm what street address information Medicare has on file for you. Your Medicare contractor will be able to advise you about what actions you need to take.