What is the effect of a crossover payment on claim creation?

• A. A new claim is automatically created
• B. No new claim is run
• C. The payment is rejected
• D. A duplicate claim is created

Answer: (B)

A crossover payment does not create a new claim. In this scenario, the payment from a secondary payer is linked to the existing claim for the same service, and the system updates that claim with the crossover payment details (such as the secondary payer information and any adjustments) rather than spawning a separate claim record. This avoids duplicating claims for the same service and keeps the claim history coherent. If a new claim were generated, it would imply duplication of the service or a separate filing, which is not how crossover processing works.