Traditional MedicareAdministrativeHigh impact
National Coordination of Benefits Agreement Medicare Part A and Medicare Part B Crossover Claims Process
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jan 1, 2018
We identified it
Jun 20, 2026
Summary
CMS now requires automatic crossover of Medicare Part A/B claims to Wisconsin BadgerCare Plus and Medicaid MCOs starting January 1, 2018. Providers must wait 30 days for automatic processing before manually submitting crossover claims, and must still manually submit claims in specific situations like Medicare Advantage enrollees or when automatic crossover fails.
Action Required
Effective January 1, 2018: Billing team must modify workflow to wait 30 days after Medicare processes claims before submitting crossover claims to ForwardHealth or MCOs. Continue manual submission for Medicare Advantage/Cost Plan members, members with commercial secondary insurance, retroactively eligible members, and when automatic crossover doesn't appear on Remittance Advice within 30 days. Use primary NPI reported to ForwardHealth when resubmitting failed crossover claims.