Cross-Over Program

Spanish translation: programa de transferencia de reclamaciones

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17:57 Dec 17, 2016
English to Spanish translations [PRO]
Medical - Medical: Health Care / Healthcare insurance
English term or phrase: Cross-Over Program
Hola a todos:
La traducción es sobre un seguro médico que les ofrece una empresa a sus empleados:

Medicare Cross-Over Program
The Plan offers a Medicare Cross-over Program for Medicare Part A and Part B and Durable Medical Equipment (DME) claims. If you enroll for this program, you no longer have to file a separate claim with the Plan to receive secondary benefits for these expenses.
Once the Medicare Part A and Part B and DME carriers have reimbursed your health care provider, the Medicare carrier will electronically submit the necessary information to the Claims Administrator to process the balance of your claim under the provisions of this Plan.

Alguna sugerencia para Cross over?
Muchas gracias!
Belén
Belen Nieto
Local time: 08:01
Spanish translation:programa de transferencia de reclamaciones
Explanation:

Introduction – Crossover Claims
Crossover is the transfer of processed claim data from Medicare operations to Medicaid (or state) agencies and private insurance companies that sell supplemental insurance benefits to Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) Coordination of Benefits (COB)program identifies the health benefits available to a Medicare beneficiary and coordinates the payment process to ensure appropriate payment of Medicare benefits. There are two ways for Medicare contractors to be notified that Medicare claim information should be crossed over to the beneficiary’s supplemental insurance company:
-Coordination of Benefits Agreement (COBA) crossovers
-Medigap claim-based crossovers
http://www.cgsmedicare.com/jc/pubs/pdf/chpt7.pdf
Selected response from:

Benigno Torres
Mexico
Local time: 06:01
Grading comment
Muchas gracias por tu ayuda, Benigno!
Saludos!
4 KudoZ points were awarded for this answer



Summary of answers provided
3programa de transferencia de reclamaciones
Benigno Torres


  

Answers


21 mins   confidence: Answerer confidence 3/5Answerer confidence 3/5
cross-over program
programa de transferencia de reclamaciones


Explanation:

Introduction – Crossover Claims
Crossover is the transfer of processed claim data from Medicare operations to Medicaid (or state) agencies and private insurance companies that sell supplemental insurance benefits to Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) Coordination of Benefits (COB)program identifies the health benefits available to a Medicare beneficiary and coordinates the payment process to ensure appropriate payment of Medicare benefits. There are two ways for Medicare contractors to be notified that Medicare claim information should be crossed over to the beneficiary’s supplemental insurance company:
-Coordination of Benefits Agreement (COBA) crossovers
-Medigap claim-based crossovers
http://www.cgsmedicare.com/jc/pubs/pdf/chpt7.pdf

Benigno Torres
Mexico
Local time: 06:01
Native speaker of: Native in SpanishSpanish
PRO pts in category: 32
Grading comment
Muchas gracias por tu ayuda, Benigno!
Saludos!
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