Medical Billing Forum

Billing => Billing => Topic started by: leanne on March 04, 2010, 01:04:04 PM

Title: Medicaid denial..Bill patient?
Post by: leanne on March 04, 2010, 01:04:04 PM
I recently received an EOB from Medicaid for a patient which denied charge as "individual has restricted coverage- Medicaid only pays the part B premium."  Patient has Medicare as primary which they applied his balance toward the deductible.  Should I write off the amount since patient does have Medicaid or bill the patient?  Not sure of the legalities in this situation.  Thank you!!
Title: Re: Medicaid denial..Bill patient?
Post by: rdmoore2003 on March 04, 2010, 01:49:50 PM
It depends on what your state laws are.  In my state, at no time can you ever bill the patient if they have medicaid and have given you permission to file their insurances.  Any patient can decide if they want their insurance filed or they may just want to pay. (depending on the diagnosis, some patients do not want their insurance to know)
Title: Re: Medicaid denial..Bill patient?
Post by: Pay_My_Claims on March 04, 2010, 06:19:31 PM
I recently received an EOB from Medicaid for a patient which denied charge as "individual has restricted coverage- Medicaid only pays the part B premium."  Patient has Medicare as primary which they applied his balance toward the deductible.  Should I write off the amount since patient does have Medicaid or bill the patient?  Not sure of the legalities in this situation.  Thank you!!

The client DOES NOT have traditional medicaid, therefore has no medicaid coverage. Their medicaid only covers the part B premium for Medicare. The patient's income is too high to have full benefits, but low enough to get help paying their part b premiums. BILL THE PATIENT. it is their responsibility!!