Our state-of-the-art Electronic Data Interchange (EDI) crossover clearinghouse provides supplemental Medicare payers a simple, convenient way to receive Medicare claim adjudication data.
Simply send us your Medicare beneficiary eligibility files on a regular basis. We'll handle the file transfers to the CMS Coordination of Benefits Contractor (COBC) and send you easy-to-process claim data — formatted and transmitted according to your business requirements. Your Medicare supplement claims throughput will increase, the volume of paper claims will be reduced and beneficiary confusion will be eliminated. But most importantly, your administrative process will be streamlined, which will reduce costs and improve your bottom line.
Since its inception, the Department of Health and Human Services has contracted with private insurance companies to administer the Medicare program. As your trading partner contractor, we'll manage the COBA process for you, assisting with your selection of appropriate claims criteria and keeping you up-to-date with the constant Medicare changes.
Upon executing a Clearinghouse Services Agreement, we perform client business-to-business testing to verify telecom connectivity, sign-on/security parameters, eligibility receipt and claim output format. We work with you to determine the file format and data transfer method used for transmitting your files.
Our competitive, fixed-cost pricing structure helps you more accurately budget expenses associated with processing Medicare claims.
Should questions arise, we coordinate all processing issues with CMS for you. No need to go through numerous phone calls or e-mails to locate the appropriate person with whom to talk. Our Crossover Help Desk business analysts work with you to get answers from multiple Medicare sources.