When crossover payers are set, Epic will perform which action on the secondary payer's claim?

When crossover payers are set, Epic will perform which action on the secondary payer's claim?

• A. suppress
• B. forward
• C. duplicate
• D. escalate

Answer: (A)

When crossover payers are configured, Epic suppresses the secondary payer's claim. In crossover processing, the primary payer’s adjudication handles the service, so there’s no need to submit a separate claim to the secondary payer. Suppressing prevents duplicate submissions and confusion for billing and patients. Forwarding would send the claim to the secondary payer, which isn’t desired in this setup. Duplicating would create an extra copy of the claim. Escalating would route the claim for manual review rather than suppressing it.

When crossover payers are configured, Epic suppresses the secondary payer's claim. In crossover processing, the primary payer’s adjudication handles the service, so there’s no need to submit a separate claim to the secondary payer. Suppressing prevents duplicate submissions and confusion for billing and patients.

Forwarding would send the claim to the secondary payer, which isn’t desired in this setup. Duplicating would create an extra copy of the claim. Escalating would route the claim for manual review rather than suppressing it.