Medicare crossovers are electronically filed claims that Medicare forwards or “crosses over” to BCBSLA automatically when the BC member is in the Medicare eligibility file. This process includes claims where Medicare is primary and BCBSLA is secondary. In addition to BCBSLA receiving claims for providers within the state of Louisiana, effective January 1, 2008, all Blue Cross and Blue Shield 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. For instance, we now receive claims for Louisiana members via the crossover process from out-of-state providers (Texas, Arkansas, etc.).

Claim sent from Medicare to a Blue Cross Plan

When a claim is crossed over from Medicare, 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 below, the claim was not forwarded electronically for processing. This claim must be filed with the Plan listed on the members ID card. For BCBSLA claims that did not crossover, we will need a paper claim along with a copy of the Medicare Remittance Advice which indicates the Medicare payments for the claim. 

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 Texas"

The above message indicates that the claim was forwarded electronically from Medicare to Blue Cross and Blue Shield of Texas for processing. When a claim is forwarded to an out-of-state Blue Plan, the state the claim was sent to will be listed in the message.

Claims Submission

• All claims for federal employee contracts (contract numbers that begin with the first letter R) and BCBSLA contracts (contracts that begin with a three letter prefix XU*) 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.
  
• If the claim indicates information was forwarded to Blue Cross and Blue Shield of Louisiana, do not submit a paper claim to us. To verify the claim crossed over, our providers may use our provider web portal iLinkBLUE to determine if the claim is on file with us:
  
• 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.

If you are unable to locate the claim in the iLinkBLUE system, please contact our EDI Clearinghouse Support team at 225-291-4334 and provide the following information: Provider number, subscriber ID, date of service, and amount charged. One of our EDI Support representatives will research and respond to your issue. 

Processing Times

• Allow at least 15-20 days from the Medicare Remittance Advice date 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 at least 25-30 days to process paymentFor follow-up, please contact the BCBS Plan on the members ID card