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Medi-cal

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mruiz12:
If we are not contracted with medi-cal and our dr. does his rounds at the hospital and we bill out of the office can we bill the patient for the balance. I tried to call medi-cal but they did not make sense to me. One of the reps stated as long as the patient is aware that your dr does not accept medi-cal then you can bill the patient. When my dr does his rounds he usually does not know what insurance they have and he is not going to see the patient if he is on call. I have been writing off all hospital charges for medi-cal patients. I do bill office visit to patients that have a share of cost and medicare is primary but that patient knows that we do not accept medi-cal. I also write off all medicar/medical patients. Please advise. ???

Pay_My_Claims:
that would be correct. you can only bill a medicaid patient for non-covered services with advanced notice of non-coverage.

Michele:
I agree with Pay_My_Claims.

Laws vary from state to state and I'm not familiar with California but in NY you cannot bill a patient who is eligible for Medicaid unless they are notified ahead of time that the provider does not accept medicaid, and they sign a release stating they are aware and agree to the services.

Michele

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