Medical Billing Forum
Billing => Billing => : Ryanne August 29, 2012, 07:45:23 PM
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Patient has Medicaid HMO as secondary insurance. Primary insurance has been billed and paid a portion of the allowed amount (provider is not network for the primary). Can the patient be balance-billed since provider is not enrolled in the Medicaid HMO? (Provider is a Medicaid provider for traditional Medicaid, but not for the Medicaid HMO Amerigroup)
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It depends on your state laws. In NYS you cannot bill a Medicaid Eligible patient.
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You can't bill patient here in California either. Also, depending on how much the primary paid, if it's more than what Medicaid allowed, they're not going to pay any more anyways.