5 Reference List Helpful Phone Numbers Web Addresses EDS Website EDI HelpdeskProvider Billing InquiryWeb AddressesEDS WebsiteKyHealthnetKyHealth Choices
6 Billing Crossovers to KyHealth Choices Beginning September 29, 2008, KyHealth Choices will require their providers to prepare their own Medicare/Medicaid related claims.If you bill these by paper, your claim form must include the Medicare information necessary for processing.You will no longer send Medicare EOB’s with your claim unless Medicare denies the service.You may bill Crossover claims by electronic means.
7 837I Claims SubmissionThe 837I Companion Guide Version 3.0 will be available on the EDS websiteContact your Software Vendor to check the capability and readiness for these changes.
9 Required Information Medicare EOB Date Form Locator 37 (new change) Medicare Paid AmountForm Locator 54 (new change)Medicare Allowed AmountForm Locator 55 (new change)Medicare Coinsurance AmountForm Locator 39Medicare Deductible Amount
10 Helpful HintsA submission on paper or by electronic means must not be sent until you are sure the Medicare electronic Crossover was unsuccessful or denied by KyHealth Choices to avoid duplicate billing.If Medicare denied your charges, the claim must still be submitted to KyHealth Choices by paper with the Medicare EOB attached.
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