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Blue Cross Community CentennialSM Retroactive Medicare Recoveries

July 27, 2017

Blue Cross Community Centennial will begin to identify claims submitted for members who have been identified as having retroactive Medicare eligibility. Claims processed with Medicaid as primary for dates of service that occurred after the member was identified as having retroactive Medicare eligibility are subject to recoupment. Medicare is primary and by law, Medicaid is the payor of last resort for most services.

Medicare may allow providers to submit claims beyond the Medicare timely filing limits for retroactive enrollment/eligibility. Please refer to the Medicare Claims Processing Manual , Section 70.7: "Exceptions Allowing Extension of Time Limit," for more detailed information on retroactive Medicare eligibility and claims processing guidelines.

After Medicare benefits are applied to your claim, it will automatically cross over to Blue Cross and Blue Shield of New Mexico for application of any Medicaid benefits. If you have any questions regarding this notice, please call 800-693-0663.