MSP Contractor, formerly known as Benefits Coordination & Recovery Center (BCRC), GHP

Crossover Claims

CMS implemented the Coordination of Benefits Agreement (COBA), which states that the MSP Contractor will process all claims crossovers. Government Health Incorporated (GHI) is the contractor selected by CMS. (Change Request (CR) 2961 dated January 5, 2004.)

The MSP Contractor consolidates the activities that support the collection, management, and reporting of other insurance coverage for Medicare beneficiaries. The purposes of the Coordination of Benefits (COB) program are to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken payment of Medicare benefits. The MSP Contractor does not process claims, nor does it handle any mistaken payment recoveries or claims specific inquiries. The Medicare intermediaries are responsible for processing claims submitted for primary or secondary payment.

For eligibility-based COBA crossovers, private insurers and Medicaid agencies supply the MSP Contractor with their eligibility file and indicate the types of claims they would like to receive. This information is stored within the Common Working File (CWF) and is used to tag Medicare claims for crossover as they are cabled to CWF for payment authorization. The claims flagged for crossover are then collected at the contractor's data center and once the claims have finalized, they are sent to the MSP Contractor. The MSP Contractor then combines all of the claims for a particular insurer and sends them to that insurer based on the terms of their COBA the insurer has on file with the MSP Contractor. When claims are crossed over to the MSP Contractor, the MA18 (supplemental insurance) and MA07 (Medicaid) codes will be reported on the remittance advice (RA).

If a beneficiary has a Medicare supplemental insurance and the claim is not crossed over, the supplier will need to submit a crossover claim to the beneficiary's crossover company manually.

Contacting the MSP Contractor

The beneficiary or beneficiary’s attorney must contact the MSP Contractor (BCRC) for questions/issues regarding MSP for questions or issues below:

Beneficiaries must contact the MSP Contractor Customer Service Representatives Monday - Friday, from 8 a.m. to 8 p.m., Eastern Time, except holidays, at toll-free lines: 1-855-798-2627 (TTY/TDD: 1-855-797-2627 for the hearing and speech impaired).

MSP Contractor Address

BCRC - GHP
P.O. Box 138897
Oklahoma City, OK 73113-8897

Beneficiary Must Contact MSP Contractor to:

  • Report employment changes, or any other insurance coverage information
  • Report a liability, auto/no-fault, or workers compensation case
  • Verify the Medicare's primary/secondary status. Note: Insurer information will not be released. The provider/supplier must request information on payers primary to Medicare from the beneficiary prior to billing. Since the MSP Contractor must protect the rights and information of our beneficiaries, they cannot disclose this information
  • Ask general Medicare Secondary Payer (MSP) questions/ concerns
  • Ask questions regarding MSP Development letters and questionnaires
  • Report changes to a beneficiary's health coverage
  • Report a beneficiary's accident/injury

MSP Contractor cannot assist with:

  • Information concerning how to bill for payment (e.g., value codes, occurrence codes) - Contact Noridian
  • Inquiries related to specific claims or recoveries - Contact Noridian
  • Information regarding beneficiary entitlement data. Current regulations do not allow the MSP Contractor to provide entitlement data to the provider
  • Insurer information. The MSP Contractor is permitted to state whether Medicare is primary or secondary but cannot provide the name of the other insurer. It is very important that the provider obtain this information from the beneficiary since the new Privacy Act prohibits the release of this information

Contact Noridian to:

  • Answer your questions regarding Medicare claim or service denials and adjustments
  • Answer your questions about how to bill for payment
  • Process claims for primary or secondary payment
  • Accept the return of inappropriate Medicare payment

 

Last Updated Oct 31 , 2023