What type of claim is automatically forwarded from Medicare to a secondary insurer after Medicare has paid its portion of a service?

The term that describes a claim automatically forwarded from Medicare to a secondary insurer after Medicare has paid its portion is a crossover claim. This process allows for seamless handling of claims where Medicare is the primary payer and another insurer, often a private insurance plan, is the secondary payer. When a claim is classified as a crossover claim, it signifies that Medicare has already adjudicated the claim, determining its payment amount and leaving the balance due to be handled by the secondary payer.

The crossover mechanism helps streamline the claims process, ensuring that healthcare providers receive payment more efficiently and reducing the administrative burden on both providers and patients. It enables patients to avoid the hassle of submitting the claim to the secondary insurer themselves, as this is done automatically.

The other types of claims mentioned do not fit this specific description. A primary claim refers to the initial claim submitted to the primary insurer (in this case, Medicare), a crosswalk claim relates to coding and data management in claims processing, and a resubmitted claim is one that is being sent again, often after corrections have been made. Only the crossover claim encapsulates the specific process of forwarding a claim from Medicare to another insurance entity post-payment.