Non-Par w/ Medicaid but patient needs care

[kclayton]

I have a question.  We are not yet approved with a few medicaid states.  We have a petient in one of those states but still wants the DME product.  Can I charge he patient even though he has medicaid (we will not be billing medicaid)?  Do I charge the patient the amount I subit to medicare?  Medicare allowable?  Thanks for your help.

[Michele]

You need to check the state laws for that state.  Each state has different laws on if Medicaid eligible patients can be billed.

[PMRNC]

In most states it's no, because they have access to a Medicaid provider. Defeats purpose of patient's eligibility of Medicaid. If the provider takes the patient it will be at their own loss.

[SLITTLES]

The patient would need to find a Medicaid provider that is contracted with their state.  Also your services should have one price regardless of payor source.

[pvtbiller]

we are a sole source manufacturer and provider so they would not be able to find a participating provider.

[Michele]

Sounds like an unusual situation.  Maybe you should contact Medicaid to find out if they make exceptions in these circumstances.