Benefits Coordination & Recovery Center (BCRC), GHP

Crossover Claims

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

The BCRC 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 BCRC 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 COBC 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 COBC. The COBC 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 COBC. When claims are crossed over to the COBC, 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.

Contact

Contact BCRC

BCRC Customer Service Representatives are available to assist you 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).

BCRC  Address

Medicare - Data Collections
P.O. Box 138897
Oklahoma City, OK 73113-8897

Contact BCRC 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 BCRC  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

BCRC 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 BCRC  to provide entitlement data to the provider
  • Insurer information. The BCRC 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 May 09, 2018