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Medicare Crossover Institutional Claim Processing Update

On April 1, 2017, the Centers for Medicare & Medicaid Services (CMS) implemented an update to its policy, Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process – Claim Coding Changes. As a result, Medicare Crossover institutional claims processed between April 1, 2017 and April 12, 2017 were inadvertently rejected by Horizon Blue Cross Blue Shield of New Jersey for missing and/or invalid data.

This issue was corrected on April 12, 2017.

Change Healthcare (formerly Emdeon) successfully resubmitted all impacted claims by April 18, 2017.

Action Required by You
Institutional providers are asked to disregard rejection letters received for Medicare Crossover institutional claims processed between April 1, 2017 and April 12, 2017.

If you have any questions about electronic transactions, please email HorizonEDI@HorizonBlue.com or call our e-Service Desk’s EDI team at 1-888-334-9242, Monday through Friday, between 7 a.m. and 6 p.m., Eastern Time.

Published on: May 3, 2017, 09:38 a.m. ET
Last updated on: May 3, 2017, 09:44 a.m. ET