Crossover claim definition

Crossover claim means a claim for Medicaid payment for Medicare-covered inpatient or outpatient hospital services rendered to a Medicare beneficiary who is also eligible for Medicaid. Crossover claims include claims for services rendered to beneficiaries who are eligible for Medicaid in any category, including, but not limited to, qualified Medicare beneficiaries and beneficiaries who are eligible for full Medicaid coverage.
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Crossover claim has the meaning set forth in Section 9.2.
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Crossover claim means a claim for Medicaid payment for Medicare-covered inpatient or outpatient hospital services rendered to a Medicare beneficiary who is also eligible for Medicaid.
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Examples of Crossover claim in a sentence

  • An example would be if the claim was submitted on a Medical claim and should have been submitted as a Crossover claim.

  • If Medicare Part B covers the NDC/HCPCS code being dispensed, a claim must be submitted to Medicare first.For a Medicare Part B Crossover claim to be successfully captured for ECCA via the variable 5.1 format, the appropriate Medicare fields must be entered.

  • After Medicare processes the claim, submit a Medicare Crossover claim to Medicaid using the UB-04 or CMS- 1500 claim form.

  • If the provider accepts assignment for Medicare Part A or Part B, the Crossover claim is sent to Medicaid Crossovers automatically from the intermediary.

  • After Medicare processes the claim, submit a Medicare Crossover claim to Medicaid using the UB-04 or CMS-1500 claim form.

  • The deadline for filing a Crossover claim is 365 days from date of service or six months after Medicare disposition.

  • After Medicare processes the claim, submit a Medicare Crossover claim to Medicaid using the CMS-1500 claim form along with a copy of the Explanation of Benefits (EOB).

  • After Medicare processes the claim, submit a Medicare Crossover claim to Medicaid using the UB-04 claim form.

  • After Medicare processes the claim, submit a Medicare Crossover claim to Medicaid using the CMS-1500 claim form.NOTE: When billing for Medicare Part B deductible and/or coinsurance, you must submit a CMS-1500 claim form with all required fields completed or the claim will be returned.

  • EXCEPTIONS: Claims submitted with a GY modifier where Medicare would otherwise be primary, claims from VA/DOD facilities, Medicare Crossover claim will not be subject to these requirements.


More Definitions of Crossover claim

Crossover claim means a claim for Medicaid payment for Medicare-covered inpatient or outpatient hospital services rendered to a Medicare beneficiary who is also eligible for Medicaid. Crossover claims include claims for services rendered to beneficiaries who are eligible for Medicaid in
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Crossover claim has the meaning set forth in Section 2.4 of this Agreement.
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Crossover claim means a claim arising out of a debt or other obligation of one or more of the U.S. Debtors that is guaranteed or indemnified by one or more of the Canadian Debtors, or a debt or other obligation of one or more of the Canadian Debtors that is guaranteed or indemnified by one or more of the U.S. Debtors, including the Crossover Bondholder Claims, the NNCC Bondholder Claims and the claims of Export Development Canada against the U.S. Debtors and the Canadian Debtors, but excluding, in relation to the Canadian Debtors, any obligation of a Canadian Debtor guaranteed by another Canadian Debtor.
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Crossover claim means a claim for Medicare Part A and/or B deductibles and coinsurance submitted to a Medicaid agency on behalf of a Dual Eligible Beneficiary.
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Related to Crossover claim

  • Priority Non-Tax Claim means any Claim other than an Administrative Expense Claim or a Priority Tax Claim, entitled to priority in payment as specified in section 507(a) of the Bankruptcy Code.

  • Secured Claim means a Claim: (a) secured by a valid, perfected, and enforceable Lien on collateral to the extent of the value of such collateral, as determined in accordance with section 506(a) of the Bankruptcy Code or (b) subject to a valid right of setoff pursuant to section 553 of the Bankruptcy Code.

  • 503(b)(9) Claim means a Claim or any portion thereof entitled to administrative expense priority pursuant to section 503(b)(9) of the Bankruptcy Code.

  • Priority Claims means, collectively, Priority Tax Claims and Other Priority Claims.

  • Other Priority Claim means any Claim other than an Administrative Claim or a Priority Tax Claim entitled to priority in right of payment under section 507(a) of the Bankruptcy Code.

  • Administrative Claims Bar Date means the deadline for Filing requests for payment of Administrative Claims, which: (a) with respect to Administrative Claims other than Professional Fee Claims, shall be 30 days after the Effective Date; and (b) with respect to Professional Fee Claims, shall be 45 days after the Effective Date.

  • Administrative Claim means a Claim for costs and expenses of administration of the Estates under sections 503(b), 507(a)(2), 507(b), or 1114(e)(2) of the Bankruptcy Code, including: (a) the actual and necessary costs and expenses incurred on or after the Petition Date of preserving the Estates and operating the businesses of the Debtors; (b) Allowed Professional Fee Claims in the Chapter 11 Cases; and (c) all fees and charges assessed against the Estates under chapter 123 of title 28 of the United States Code, 28 U.S.C. §§ 1911-1930.

  • Allowed Claim means an Allowed Claim of the type described.