- Dental Services
- Dental Services
- Enrolling in Medicare
- Medicare Coverage Exclusion: Dental Services
- Claim Submission Guidelines
- Medical Documentation Requirements
- New Medicare Provider
- Additional Development Request Letters Guide
- Medicare Coverage Exclusion: Dental Services
- Inpatient Services in Connection With Dental Procedures
- The Utilization of the KX Modifier on Dental Claims
- Modifier GY
- Standard Companion Guide Health Care Claim: Dental (837D)
- 837D Edit Spreadsheet
- Dental Claim Cross Over
- Attention Clearinghouses and Vendors!
- Resources
Dental Claim Cross Over
Medicare contractors coordinate with the BCRC, GHI, to automatically cross over claim payment information for their policyholders as a courtesy.
An eligibility file furnished by the supplemental insurer is used to drive the process. These eligibility files are matched, based on the Medicare ID, against Medicare's internal eligibility file. If a match occurs, the beneficiary's record is flagged indicating to which company we will cross claim payment information. The file of claims is then sent to the BCRC who forwards the file on to the trading partner/supplemental insurer. If no match occurs, the claim is not flagged for cross over.
Each trading partner/supplemental insurer is given the opportunity to specify criteria related to the claims the insurer wants or does not want Medicare to cross over.
At this time, 837D dental claims will not be crossed over to trading partners/supplemental insurers.
Posted 6/20/2024