Blue Cross Newsletter
 

July 26, 2010

BC-10-11
HP-10-10
SA-10-10

HHA-10-10
DC-10-09
MS-10-10

To: All Blue Cross Contracting Providers
From:

Cindy Garrison, CPC – Education/Communication Coordinator
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

Medicare Part A Crossover Problem

The Coordination of Benefit Contractor (COBC) recently notified Blue Cross and Blue Shield of Kansas (BCBSKS) of an issue with the Medicare Part A system that is only effecting the 837 institutional claims.  On June 7, 2010, The Centers for Medicare & Medicaid Services (CMS) implemented a fix that began using a new table that had incorrect information.  This resulted in COBC rejecting only Medicare Part A claims due to non-compliance.

CMS is targeting a fix to correct the matter in early September 2010.  Until then, PROVIDERS YOU DO NEED TO SUBMIT THESE CLAIMS TO US.

We prefer that you submit your BCBSKS secondary claims to us electronically.  Due to this unfortunate difficulty in the Medicare Part A crossover, our Electronic Data Interchange (EDI) department has temporarily implemented a change (until the Medicare fix is implemented) to allow Medicare secondary to BCBSKS claims to be filed without waiting 15 days from the Medicare RA date.

Remember, that an electronically submitted claim must reflect:

  • all necessary payment information indicated on the Medicare RA (ie patient responsibility, Medicare allowable, etc)
  • the Medicare Adjudication Date in 2330B with a 573 qualifier.

And a paper submitted claim must include:

  • the Medicare RA.  Circle or mark the payment information that needs to be processed (limit one request per page).
    1. If there are multiple payments or patients on the Medicare RA, duplicate that page and submit a separate copy for each case that needs handled.
    2. Make sure the patient's name and BCBSKS identification number is reflected on the Medicare RA.

If you have any questions regarding the submission of an electronic claim, please contact our EDI department at 1-800-472-6481.

cg