A Medicare/Medicaid crossover claim submitted by a participating provider requires what patient responsibility percentage?

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Multiple Choice

A Medicare/Medicaid crossover claim submitted by a participating provider requires what patient responsibility percentage?

When a patient has both Medicare and Medicaid, Medicare pays first and Medicaid acts as the secondary payer for crossover claims. With a participating provider, Medicaid covers the portion of the cost-sharing (deductible and coinsurance) that Medicare would normally bill the patient. Because Medicaid takes care of those patient cost-sharing amounts on crossover claims for dual eligible individuals, there is no patient portion left to pay. So, the patient responsibility percentage on a Medicare/Medicaid crossover claim submitted by a participating provider is 0%.

When a patient has both Medicare and Medicaid, Medicare pays first and Medicaid acts as the secondary payer for crossover claims. With a participating provider, Medicaid covers the portion of the cost-sharing (deductible and coinsurance) that Medicare would normally bill the patient. Because Medicaid takes care of those patient cost-sharing amounts on crossover claims for dual eligible individuals, there is no patient portion left to pay. So, the patient responsibility percentage on a Medicare/Medicaid crossover claim submitted by a participating provider is 0%.

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