Update on Denial of Crossover Claims if Medicare Denies

UPDATE: The NC Division of Medical Assistance (DMA) is revising the processing of crossover claims when Medicare Part C has denied a line on the claim. This is an addendum to a previous announcement regarding NCTracks denying lines because of a crossover with Medicare Part B.

Effective December 31, 2017, if Medicare Part C has denied the line on a crossover claim, NCTracks will also deny the line with EOB 01760 - CLAIM INDICATES MEDICARE IS PRIOR PAYER, BUT NO MEDICARE ALLOWABLE AMOUNT IS INDICATED FOR THIS DETAIL.

Guides and additional information: If the claim was denied by Medicare due to billing issues, the provider should submit a corrected claim to Medicare. Otherwise, refer to the User Guide "How to Indicate Other Payer Details on a Claim in NCTracks and Batch Submissions" on the Provider User Guides and Training page of the NCTracks Provider Portal for information on the process for billing secondary claims to NCTracks.