100-04 Medicare Claims Processing Manual: Chapter 28 Crosswalk

Medicare Claims Processing Manual
Chapter 28 - Coordination With Medigap, Medicaid, and Other Complementary Insurers
Crosswalk
Chap. 	Sect. 	Int.
Pub.13.
Carrier
Pub. 14
HO
Pub. 10
P.M. 	RO
Office
Manual
Description
28 	10 	B3-4700 	Medigap - Definition and Scope
28 	20 	B3-4702,
B3-3047
Assignment of Claims and Transfer Policy
28 	20.1 	B3-4702.1,
B3-3047,
B4-2110.1
Beneficiary Insurance Assignment Selection
28 	30 	B1-2010,
B3-4702
A-01-20,
A-01-63
Completion of the Claim Form
28 	30.1 	B1-2010,
B3-4702
A-01-20,
A-01-63
Form CMS-1500 (ANSI X12N 837 COB (Version 4010))
28 	30.2 	A3-3604 	HO-460 	UB-92 (Form CMS-1450)
28 	40 	B3-4703 	AB-99-3,
AB-01-155
MSN Messages
28 	50 	B3-4704 	AB-99-3,
B-01-35,
A-01-57
Remittance Notice Messages
28 	60 	B3-4705 	AB-99-3 	Returned Medigap Notices

Chap. 	Sect. 	Int.
Pub.13.
Carrier
Pub. 14
HO
Pub. 10
P.M. 	RO
Office
Manual
Description
28 	70 	A1-1601,
A3-3768 -
A3-3769
B1-4607,
B3-4701,
B3-4706
Coordination of Medicare with Medigap and Other
Complementary Health Insurance Policies
28 	70.1 	A1-1600 -
A1-1602.5,
A3-3768,
A3-3769
B1-4600 -
B14602.5,
B3-10010
Authorization for Release of Information
28 	70.1.1 	Requests for Additional Information
28 	70.1.2 	HO-91.3 	Release of Title XVIII Claims Information for Medigap
Insurance Purposes by Providers
28 	70.2 	A3-3769 	Integration of Title XVIII Claims Processing with
Complementary Insurance Claims Processing
28 	70.2.1 	Program Recognition
28 	70.2.2 	A3-3769C 	Records and Information
28 	70.2.3 	A3-3769D 	Matching Files Against Medicare Claims Files
28 	70.3 	A1-1600 	B1-4601 	Standard Medicare Charges for COB Records
28 	70.4 	B1-4607 	General Guidelines for Intermediary or Carrier Transfer of
Claims Information to Medigap Insurers
28 	70.5 	A1-1601C 	B1-4601 	Audits

Chap. 	Sect. 	Int.
Pub.13.
Carrier
Pub. 14
HO
Pub. 10
P.M. 	RO
Office
Manual
Description
28 	80 	B3-4707 	A-01-20,
A-01-63,
B-01-06
Electronic Transmission - General Requirements
28 	80.1 	A-01-20 	HIPPA Provisions Affecting Medigap Transactions
28 	80.2 	ANSI X12N 837 COB (Version 4010) Transaction Fee
Collection
28 	80.3 	B3-4709,
B4-2110.1
Medigap Electronic Claims Transfer Agreements
28 	80.3.1 	A-01-20,
A-02-069,
A-02-077,
A-02-078,
AB-02-20
Intermediary Crossover Claim Requirements
28 	80.3.2 	B-01-32,
B-01-06
Carrier/DMERC Crossover Claim Requirements
28 	90 	B3-4708 	Paper Submission
28 	100 	A-00-23 	RO-2700 	Medigap Insurers Fraud Referral
28 	110 	RO-2700 	Medigap Criminal Penalties/Types of Complaints under
Subsection 1882(d)
28 	110.1 	RO-2700 	Outline of Complaint Referral Process

Chap. 	Sect. 	Int.
Pub.13.
Carrier
Pub. 14
HO
Pub. 10
P.M. 	RO
Office
Manual
Description
28 	110.2 	RO-2700 	Preliminary Screening and Referral to Regional Office of
the Inspector General
28 	110.3 	RO-2700 	CMS Regional Office Quarterly Report on Medicare
Supplemental Health Insurance Penalty Provision Activity
28 	110.3.1 	RO-2700 	Statistics
28 	110.3.2 	RO-2700 	Narrative