Back to dashboard
MedicaidAdministrativeMedium impact

Resubmitting Medicare Crossover Claims When Medicare Assessed a Late Fee

Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Feb 1, 2010
We identified it
Jun 20, 2026
Days to comply
—

Summary

ForwardHealth now allows resubmission of Medicare crossover claims that were denied due to Medicare late fees. When resubmitting electronically, providers must add the late fee amount to the Medicare paid amount to balance the claim, while paper submissions require attaching Medicare remittance information.

Action Required

Action needed
Immediately: Billing team must update crossover claim resubmission procedures for Wisconsin Medicaid/BadgerCare Plus. For electronic submissions (Portal or 837 transactions), add Medicare late fee amount to the paid amount field before resubmitting. For paper claims, attach Medicare remittance showing B4 code (late filing penalty). Monitor Medicare remittance for ANSI code B4 to identify claims with late fees that need rebalancing.

Related policy hubs