Medical Billing Forum

General Category => New! => : awedding4you November 11, 2008, 10:00:18 AM

: Billing Medicare / Medicaid
: awedding4you November 11, 2008, 10:00:18 AM
If a pt has Medicare and Medicaid and the provider of service is not a participant with Medicaid  can we the provider bill the patient for the 20% Medicare doesn't cover.
: Re: Billing Medicare / Medicaid
: Michele November 11, 2008, 12:06:18 PM
It may differ from state to state, but in NY the answer is no.

Michele
: Re: Billing Medicare / Medicaid
: Amit_Nischal July 14, 2009, 05:20:35 PM
As i know, in NJ, NY, FL you can not bill pt for the medicare leftover, should be written off. For Maryland state (exception state), can bill pt. for the balance.
: Re: Billing Medicare / Medicaid
: Pay_My_Claims July 14, 2009, 08:40:28 PM
Its going to cross over from Medicare...then what???
: Re: Billing Medicare / Medicaid
: Amit_Nischal July 15, 2009, 03:42:11 PM
Charlene,

If medicare crossover happens, still can't bill pt. Provider must have enrollment with medicaid.

Thanks,
Amit
: Re: Billing Medicare / Medicaid
: Pay_My_Claims July 15, 2009, 06:10:09 PM
Amit, I know you can't bill the client, the question was...
Client has medicare & medicaid. Medicare pays and the claim crosses to medicaid..what happens to the claim!!!!!
: Re: Billing Medicare / Medicaid
: PMRNC July 15, 2009, 07:47:22 PM
You'll still get an EOB, if provider is non par it will say so with Zero payment.
: Re: Billing Medicare / Medicaid
: Pay_My_Claims July 15, 2009, 07:54:23 PM
You'll still get an EOB, if provider is non par it will say so with Zero payment.


Thank you!!