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Endeavor Provider Paid Amount (Claim Level) Bill Type Specialty Total Deductible Part A/Part B/DME Both Part A Part B Part B/DME Both Both Both Receipt Date Part A/Part B/DME Full Claim Beneficiary State DME Full Claim MSP Ind. Part A/Part B Full Claim Crossover Ind. Part A/Part B/DME Full Claim Total amount paid to the provider Type of Bill Physician Specialty Code Dollar amount applied to the beneficiary’s deductible for this claim Date of which the claim was received State the beneficiary resides in according to Social Security Y indicates Medicare is the secondary payer N indicates Medicare is the primary payer Y indicates the claim is a crossover claim N indicates it is not a crossover Late Worked Date Part A/Part B/DME Full Claim Non-Covered Charges Part A (Claim Level) Full Claim Location Part A Full Claim Line Part A/Part B/DME Both June 2013 A crossover claim is automatic electronic transfer of payment information on finalized claims to the supplemental insurance companies and Medicaid that have signed agreements. Date of the last time the claim was examined by an operator Charges not covered by Medicare, Medicaid, or private health insurance Describes the queue where the claim is currently situated and the action that needs to be performed on the claim Service line number of the claim Page 13 of 26 Endeavor User Manual
