Effective January 1, 2008, all our plans established a standardized Medicare Crossover Agreement with Centers for Medicare & Medicaid Services. This standard agreement will require that crossover claims be sent directly from the Medicare Crossover Carrier, Group Health Inc. (GHI), to the member's BCBS Plan.   

Crossover Problems and Exclusions

• All claims for federal and regular BCBSLA contracts from participating Medicare payers should automatically crossover unless we do not have the patient’s Medicare HIC number in our files or the HIC number we have is incorrect.
• Some groups are exempt from the crossover process and the following claims are excluded:
  
  • Original Medicare claims paid at 100%
  • 100% denied claims with no additional beneficiary liability 
  • Adjustment claims that are non-monetary/statistical 
  • Medicare Secondary Payer (MSP); claims for which other insurance exists for beneficiary 
  • National Council for Prescription Drug Programs (NCPDP)

Processing Times

• Allow at least 15-20 days for your Blue Cross payment to process
  
  • Go to https://www.bcbsla.com/ilinkblue to follow-up (For registered iLinkBLUE users) 
  • Not a registered iLinkBLUE provider, call our support line at 225.295.5465/1-800.216.2583, or email us: ilinkBlue.providerinfo@bcbsla.com to be set up 
    
• Out-of-state claims should allow atleast 25-30 days to process payment
  
  • For follow-up, please contact the BCBS Plan on the members ID card

Claim sent from Medicare to a Blue Cross Plan
You will receive a message beneath the patients claim information on the Medicare remittance advice. If the remittance does not contain a message similar to the examples, the claim was not forwarded electronically for processing. This claim must be filed with the Plan listed on the members ID card. 

Example 1: "Claim information forwarded to: BCBS of Louisiana-Supplemental"  
                     The above message indicates that the claim was forwarded electronically from Medicare to Blue Cross and Blue Shield of Louisiana for processing. 

Example 2: "Claim information forwarded to: BCBS of Alabama"
                    The above message indicates that the claim was forwarded electronically from Medicare to Blue Cross and Blue Shield of Alabama for processing.   

Claims Submission

• Do not submit a paper claim to us until you have verified that the claim did not cross over automatically from the Medicare payer
  
  • Our members may use our provider web portal to determine if the claim is on file with us prior to filing the claims
  • Registered iLinkBLUE users should visit https://www.bcbsla.com/iLinkBLUE and use the claim status application
  • Non-registered users may view our iLinkBLUE page for more information

• File a paper claim along with a copy of the Medicare remittance advice directly to the plan listed on the members identification card