Medical Billing Forum

Payments => Insurance Payments => Topic started by: camedbill on March 04, 2011, 10:49:20 AM

Title: Medicaid
Post by: camedbill on March 04, 2011, 10:49:20 AM
Does anyone know if a Medicaid provider can accept cash from a Medicaid patient for a service that Medicaid doesn't cover?  or is the provider not allowed to by contract?
Title: Re: Medicaid
Post by: Michele on March 05, 2011, 09:14:41 AM
Medicaid is state sponsored so the laws vary from state to state.  You need to check your state laws.  Also, is it a service that is never covered? Is the provider a Medicaid provider, but this particular service isn't covered?

In NY, you can bill a Medicaid patient for services that are not covered if the patient is made aware and agrees to pay PRIOR to the services being rendered.

Title: Re: Medicaid
Post by: camedbill on March 07, 2011, 07:07:17 PM
I check with California Medicaid and it is same as you have stated.  Thank you!
Title: Re: Medicaid
Post by: BREWERBILLING on March 09, 2011, 11:20:48 AM
I am in Alabama. Toward the end of the year we run into Patient's who have run out of Medicaid visits. We were told we could bill/charge them for the standard self pay office visit but nothing more.  We tell our patients this up front because we collect up front most of the time in that situation. Anything else we cannot bill them for. If we give them a breathing treatment and Medicaid denies -- we cannot bill them for anything.  Definitely check with you MD office for specifics, but that is what AL allows.
Title: Re: Medicaid
Post by: midwifebiller on March 09, 2011, 08:11:10 PM
You can charge your patients for services that are NOT covered by Medicaid.  But, in order to do this, they need to sign a document before services are rendered.  The doc has three parts:
1. I (patient) understand these services are not covered by Medicaid;
2. I want/need these services;
3. I agree to pay out of pocket for these services.

As long as you have this signed doc on file, your backside is covered.
Title: Re: Medicaid
Post by: QueenAlicia on March 10, 2011, 01:52:54 PM
Should this document be something that they already have in the office or is this one that needs to be created?
Title: Re: Medicaid
Post by: rdmoore2003 on March 10, 2011, 02:51:34 PM
Be very careful with any medicaid state.   I have spoken with our medicaid provider rep many times. (She is responsible for half of our state)  My frustration is that she has told me many times, that she does not understand the information herself.   Our state recently had changes, she could not tell me an answer even after she took it to the "upstairs" people as she put it.  She said she just doesnt understand and to go over her head, each time you speak with a supervisor, or a supervisor's supervisor, you get different info every single time.
Title: Re: Medicaid
Post by: Michele on March 11, 2011, 07:32:50 AM
Each provider should have one, but many don't.  

Good point RD, I have experienced the same frustration.  Hard when you call for clarification and they can't help you!

Title: Re: Medicaid
Post by: camedbill on March 13, 2011, 06:31:06 PM
You just need to know to question the answer you are given cuz didn't you hear they scrape the pit of the barrels to staff state agencies?  :D