Which statement best distinguishes a crossover payer from an alternate payer?

• A. The crossover payer is the same as the primary payer
• B. An alternate payer handles charges for specific services while a crossover payer receives the claim from Medicare as the secondary payer
• C. They are the same payer
• D. Crossover payer is always the secondary payer

Answer: (B)

Understanding payer roles in Medicare billing helps. A crossover payer is the insurer that Medicare forwards the claim to after Medicare processes the claim as the primary payer; essentially, Medicare passes the claim to a secondary payer to coordinate benefits or pay remaining charges. An alternate payer is a different payer designated to handle charges for specific services under the patient’s plan, not necessarily tied to the Medicare cross‑over process.

The statement that best distinguishes them is that an alternate payer handles charges for specific services, while a crossover payer receives the claim from Medicare as the secondary payer. This captures the functional difference: alternate payer coverage is service‑specific, whereas the crossover payer is involved in the Medicare secondary claim flow.