All Blue Plans automatically cross over Medicare claims for services covered under Medigap and Medicare Supplemental products to secondary payers. These automatic submissions eliminate the need for your office or billing service to submit an additional claim to the secondary carrier.
How to submit Medicare primary/Blue Plan secondary claims?
When you receive the remittance advice from the Medicare intermediary, verify that the claim has been automatically forwarded (crossed over) to the Blue Plan.
If the remittance indicates that the claim was crossed over, Medicare has forwarded the claim on your behalf to the appropriate Blue Plan and the claim is in process.
There is no need to resubmit that claim to BlueShield of Northeastern New York.
When should I expect to receive payment?
The claims submitted to the Medicare intermediary will be crossed over to the Blue Plan only after they have been processed by the Medicare intermediary. This process may take up to 14 business days. This means that the Medicare intermediary will be releasing the claim to the Blue Plan for processing about the same time you receive the Medicare remittance advice. As a result, it may take an additional 14-30 business day for you to receive payment from the Blue Plan.
What should I do in the meantime?
If you submitted the claim to the Medicare intermediary/carrier, and haven’t received a response to your initial claim submission, don’t submit another claim. Always:
Sending another claim or having your billing agency resubmit claims automatically actually slows down the claim payment process and creates confusion for the member.
If you have additional questions, please call BlueShield at 1-518-220-5700 or 1-800-459-7587.