Home
Forms Library
MEDICARE CROSSOVER CLAIMS PROVIDER

MEDICARE CROSSOVER CLAIMS PROVIDER 2025

MEDICARE CROSSOVER CLAIMS PROVIDER Preview on Page 1

See details

4.9 out of 5

20 votes

The document outlines an agreement between the Oklahoma Health Care Authority (OHCA) and a healthcare provider for the provision of services to Medicaid-eligible individuals, specifically focusing on Medicare crossover claims. It details the responsibilities of both parties, including compliance with Medicaid regulations, billing procedures, payment terms, confidentiality requirements, and conditions for termination of the agreement. The provider is required to maintain proper documentation and adhere to various federal and state laws while ensuring that services are provided without discrimination.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out MEDICARE CROSSOVER CLAIMS PROVIDER with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the MEDICARE CROSSOVER CLAIMS PROVIDER document in the editor.
Begin by filling in your Provider Name and Provider Number at the top of the form. Ensure that this information is accurate as it identifies you within the system.
In Article I, review the purpose of the agreement. This section outlines your responsibilities regarding health-care services for Medicaid-eligible persons.
Proceed to Article II, where you will need to confirm your understanding of both parties involved. Make sure to provide your mailing address accurately in the designated fields.
Complete Article IV by detailing the scope of work. Here, you will certify compliance with Medicaid statutes and regulations, ensuring all necessary documentation is included.
Finally, sign and date the document at the end of the form. This step is crucial as it validates your agreement and commitment to adhere to its terms.

Start using our platform today for free to streamline your MEDICARE CROSSOVER CLAIMS PROVIDER form completion!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do Medicare crossover claims work?

When a Medicare beneficiary is a dual eligible meaning they have Medicare and Medicaid Medicare will process the claim first and then send it to Medicaid via the crossover process. Medicaid will then cover the cost-sharing (deductibles, co-pays and coinsurance) thats left over after Medicare has paid its share.

Does Medicare automatically crossover to secondary insurance?

The Benefits Coordination Recovery Center (BCRC) serves as the national claims crossover contactor and administers Medicare claims crossover functions on CMSs behalf.

What is a crossover only provider?

Crossover Only providers are those providers who are enrolled in Medicare, not enrolled in Medi-Cal, and provide services to dual-eligible beneficiaries. Dual-eligible beneficiaries are those beneficiaries who are eligible for coverage by Medicare (either Medicare Part A, Part B or both) and Medi-Cal.

Who sets up the Medicare crossover?

If Medicare approves the claim, it must then be billed to Medi-Cal as a crossover claim. California law limits Medi-Cals reimbursement of coinsurance and deductibles billed on a crossover claim to an amount that, when combined with the Medicare payment, should not exceed Medi-Cals maximum-allowed amount for similar

Try more PDF tools