Which describes the term 'crossover' as it relates to Medicare?

• A. When an insurance company transfers data to allow coordination of benefits of a claim
• B. When a patient transfers to another provider
• C. When a claim is split into multiple submissions
• D. When Medicare denies a claim

Answer: (A)

Crossover refers to the automatic sharing of claim data from Medicare to a secondary payer so benefits can be coordinated for one service. When a patient has both Medicare and another payer (like Medicaid or a supplemental plan), Medicare forwards the claim information to that secondary payer, allowing them to review and pay their portion without the patient having to file a separate claim. This coordination helps prevent duplicate payments and ensures the second payer contributes as appropriate. It isn’t about a patient transferring care to a new provider, splitting a claim into multiple submissions, or Medicare denying a claim.