Medical Billing Forum
Billing => Billing => : Michele March 11, 2008, 05:57:36 PM
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Question
When billing Medicaid as a secondary what form do you use. Also, do you need to submit the primary eob onto the claim. I not yet submitted a secondary claim to Medicaid yet, so any help would be appreciated. Thanks.
Answer
Hi,
Usually Medicaid provides special forms for submitting paper claims. You should contact your local Medicaid office to obtain the forms. These forms have fields to indicate that Medicare or another insurance is prime, and also to indicate the Medicare or other insurance allowed and paid amounts. You do not attach a copy of the eob to the claim, you just indicate in the appropriate fields what the other insurance is and what they allowed and paid on the claim.
Michele
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I do billing for a hospital for Masshealth. I am questioning the response below which states the EOB of the primary is not needed for Medicaid secondary. It has always been my experience that Masshealth will deny without the EOB and have gotten that response from Masshealth Claims services as well. Do you have documenation from Masshealth stating this? thanx Christine
Question
When billing Medicaid as a secondary what form do you use. Also, do you need to submit the primary eob onto the claim. I not yet submitted a secondary claim to Medicaid yet, so any help would be appreciated. Thanks.
Answer
Hi,
Usually Medicaid provides special forms for submitting paper claims. You should contact your local Medicaid office to obtain the forms. These forms have fields to indicate that Medicare or another insurance is prime, and also to indicate the Medicare or other insurance allowed and paid amounts. You do not attach a copy of the eob to the claim, you just indicate in the appropriate fields what the other insurance is and what they allowed and paid on the claim.
Michele
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I'm not familiar with Masshealth. When billing NY Medicaid secondary you cannot attach an eob. You must indicate the info on the Medicaid form. The other states I've dealt with were the same, but I haven't ever done Masshealth. Do you file on CMS forms or special Medicaid forms?
If anyone has any experience in billing Masshealth, please share any info you have.
Thanks
Michele