Does Resolute generate another claim for crossover payers?

Does Resolute generate another claim for crossover payers?

• A. Yes, always
• B. Yes, but only for certain services
• C. No
• D. It creates a credit instead

Answer: (C)

When a payer crossover happens, Resolute handles it without creating a separate new claim for the secondary payer. The claim is submitted and adjudicated with the primary payer, and then the system uses crossover logic to bill the secondary payer using the same claim data, with any secondary payment posted to that same claim record. This avoids duplicating claims and keeps the workflow streamlined for dual-eligibility scenarios (for example, Medicare primary with Medicaid secondary).

When a payer crossover happens, Resolute handles it without creating a separate new claim for the secondary payer. The claim is submitted and adjudicated with the primary payer, and then the system uses crossover logic to bill the secondary payer using the same claim data, with any secondary payment posted to that same claim record. This avoids duplicating claims and keeps the workflow streamlined for dual-eligibility scenarios (for example, Medicare primary with Medicaid secondary).