The Pulse

Connecticut Department of Social Services - Medicare Crossover Claims
Recently, there was a change in how EDS will receive Medicare crossover claims. The Centers for Medicare and Medicaid Services (CMS) has partnered with a Coordination of Benefits Contractor (COBC), Group Health Incorporated (GHI) to consolidate all Medicare claims processing. As a result, in the near future EDS will no longer receive crossover claims from any of the fiscal intermediaries. Fiscal intermediaries will pass their claims to GHI, then GHI will forward all paid claims for clients that are dual eligible to EDS for processing.

Providers are not required to take any action. However, as a result of this transition, providers may experience a slight delay for crossover claims to process with the Connecticut Medical Assistance Program.

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