Medical Billing Forum

Payments => Insurance Payments => : Migualla August 28, 2009, 03:13:15 PM

: Medicare/Medicaid crossovers payment questions
: Migualla August 28, 2009, 03:13:15 PM

Was just wondering if anyone is located in MO?   WPS implemented their new J5/MAC conversion and we received our 1st Medicaid R/A.. I have a ton of questions about what the heck happened and if others had a huge reduction in pay from Medicaid??  Thanks in advance

: Re: Medicare/Medicaid crossovers payment questions
: PMRNC August 28, 2009, 04:06:04 PM

Try this link: http://www.wpsic.com/medicare/j5macpartb/publications/news/archived/2009_0706_mcsmerge.shtml

: Re: Medicare/Medicaid crossovers payment questions
: Migualla August 28, 2009, 04:39:16 PM

Thank you for the link!  I read most all that applies but still am wondering how come there was such a reduction in payment from state medicaid.  I received a new medicare r/a today and it seems to be back to the previous payment amounts.  So, I am wondering if the one prior was just in error since the conversion and if it is an error do I need to refund state medicaid and then resubmit and hope it pays correctly this time around???  Not sure what to do from here???  Thanks

: Re: Medicare/Medicaid crossovers payment questions
: PMRNC August 28, 2009, 08:27:22 PM

I would call them and find out, it's possible that it crossed during the transition.