Crossover relationships can be configured at which levels?

Study for the RHB330 Resolute Hospital Billing Claim and Remittance Test with questions, hints, and explanations. Enhance your billing skills and excel in your exam!

Crossover relationships are the rules that determine when a claim should be passed from one payer to another as part of coordination of benefits. These can be configured both for the payer as a whole and for individual plans. Setting crossovers at the payer level creates universal behavior that applies to all plans under that payer, such as automatically forwarding eligible primary-payer crossovers to a designated secondary payer. Setting them at the plan level allows tailoring to the plan’s specific contracts and benefits, including exceptions or overrides that aren’t appropriate for every plan under the payer. Having both levels provides the necessary flexibility: you maintain consistent, payer-wide routing while also accommodating plan-specific COB requirements. If crossover rules were limited to only one level, you’d lose either broad standardization or the ability to handle plan-specific negotiations, which is why configuring crossovers at both levels is the most complete approach.