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March 17, 2010

Claims Secondary to Medicare

As a follow-up to Blue Shield Report S-02-09 which indicated a 45-day waiting period on claims that are submitted secondary to Medicare, providers will now only need to wait 15 days AFTER the Medicare payment/nonpayment date before submitting an electronic OR paper claim to Blue Cross and Blue Shield of Kansas (BCBSKS) for processing.

In most cases, Medicare will automatically transfer the claim information to BCBSKS. There may be situations that could prevent the automatic crossover process from occurring. It is important to monitor the Medicare Remittance Advice (RA) to determine whether the claim information crossed over to BCBSKS. When you find situations where the Medicare RA indicates the claim did not cross over to BCBSKS, please contact our customer service center to help resolve these instances.