NHA Certified Clinical Medical Assistant (CCMA)Administrative TasksHard

A medical assistant is processing a claim for a patient who has Medicare as their primary insurance and a Medigap plan as their secondary insurance. The Medicare payment summary indicates that Medicare paid 80% of the approved amount, and the patient's deductible has already been met. Which of the following actions should the medical assistant anticipate next regarding the Medigap plan?

  1. ASubmit a new claim to the Medigap plan for the full original charge.
  2. BSend the remaining 20% balance directly to the patient for payment.
  3. CContact the patient to obtain authorization before billing the Medigap plan.
  4. DThe Medigap plan will automatically be billed for the remaining 20% after Medicare's payment.
Show answer & explanation

Correct answer: D. The Medigap plan will automatically be billed for the remaining 20% after Medicare's payment.

Medigap plans (Medicare Supplement Insurance) are designed to cover the 'gaps' in Medicare coverage, such as the 20% coinsurance Medicare doesn't pay. When Medicare is primary and a Medigap plan is secondary, the claim typically 'crosses over' electronically to the Medigap plan for processing of the remaining balance after Medicare's payment, without requiring a separate submission from the provider's office.

Why the other options are wrong

  • A. Submitting a new claim for the full original charge is incorrect and inefficient; the Medigap plan only needs to process the remaining balance after Medicare's payment.
  • B. Sending the balance directly to the patient bypasses the secondary Medigap insurance, which is designed to cover this portion.
  • C. Authorization is generally not required to bill a secondary insurance like Medigap once the primary (Medicare) has processed the claim, as the patient has already consented to its use.

Medicare Crossover Claims (Medigap)

The automatic electronic transmission of a claim from Medicare to a Medigap (Medicare Supplement) plan for secondary payment after Medicare has processed its primary portion of the claim.

  • Designed to simplify billing for providers and patients.
  • Covers patient cost-sharing (deductibles, coinsurance) left by Medicare.
  • Eliminates the need for providers to submit a separate claim to the Medigap plan.
  • Requires the Medigap plan information to be on file with Medicare.

Memory trick: Medicare 'CROSSES OVER' the bill, Medigap catches the rest.

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