Author Topic: Medicaid billing  (Read 7816 times)

Michele

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Re: Medicaid billing
« Reply #15 on: July 02, 2009, 10:23:07 PM »
OK now I've done it!  I got deeper into this topic than I wanted to.  I honestly don't understand it, but I know in one case in particular family income is < $70000 annually, so I'm thinking no way it's income based.  But I'm now leaving this topic because I should know better than to do the forum this late at night, especially after the day I had!   ::)

Michele
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PMRNC

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Re: Medicaid billing
« Reply #16 on: July 02, 2009, 10:35:40 PM »
Quote
The cases I was specifically referring to were not income based.  Both parents work, both make decent $ (especially the husband) and have a family of 4.  The eligibility for their son was solely on his disability.  They were informed by their case worker that they could get medicaid to cover their sons copays

Yes I know that is true of a few states, PA was one of them I believe..but like Charlene Mentioned.. they still are the last payor. 
Linda Walker
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Pay_My_Claims

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Re: Medicaid billing
« Reply #17 on: July 03, 2009, 06:51:28 AM »
Quote
it may vary as far as the criteria is concerned about obtaining medicaid, but what is across the board is that if you have medicaid from any state, it is always billed last. Medicaid will never be the primary payor to any insurance.

Yes I know.. LOL I think you keep missing my sarcasm.. Let's just say I've seen cases where Medicaid was the primary payor. I didn't say it was right.. :o

LOL, oops yeah I guess I did!!

Pay_My_Claims

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Re: Medicaid billing
« Reply #18 on: July 03, 2009, 06:53:49 AM »
The cases I was specifically referring to were not income based.  Both parents work, both make decent $ (especially the husband) and have a family of 4.  The eligibility for their son was solely on his disability.  They were informed by their case worker that they could get medicaid to cover their sons copays.

Michele


Yes you can get it based upon a disability. We have medicaid for the blind, for the mentally handicapped, we also have limited medicaid programs, that only pay for the part-b premiums (income based), medicaid for pregnant women, family planning medicaid etc.

Michele

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Re: Medicaid billing
« Reply #19 on: July 03, 2009, 11:18:59 AM »
Well that is one thing we definitely all agree on, Medicaid is ALWAYS the last payor!   ;D

Michele
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PMRNC

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Re: Medicaid billing
« Reply #20 on: July 03, 2009, 03:10:51 PM »
Actually.. I remember now.. If Champus is involved THEY become last payor.  :D
Linda Walker
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Pay_My_Claims

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Re: Medicaid billing
« Reply #21 on: July 03, 2009, 03:30:29 PM »
Actually.. I remember now.. If Champus is involved THEY become last payor.  :D

No, Champus & Tricare is last to everyone except medicaid. This is the only time they (champus/tricare) is primary

Pay_My_Claims

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Re: Medicaid billing
« Reply #22 on: July 03, 2009, 03:39:33 PM »
I will attach the link, but here is the overall statement....

if you have other health insurance
(OHI), do you know how those
benefits coordinate with TRICARE?
Understanding some basic guidelines
can help ensure that your claims are
paid correctly and without hassle.
Depending on the type of OHI plan you
have, your OHI may be required to pay
before TRICARE makes a payment.
Special situations arise if you are entitled
to a public program, such as Medicare,
Medicaid or the Indian Health Service.
TRICARE pays second to Medicare,
but is primary to Medicaid and the
Indian Health Service


http://74.125.47.132/search?q=cache:KR1w5ks0ODsJ:https://www.hnfs.net/res/tricare/beneficiary/home/pdf/-1603094169/BeneBullIssue62005final.pdf+tricare,+medicaid+primary&cd=10&hl=en&ct=clnk&gl=us

PMRNC

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Re: Medicaid billing
« Reply #23 on: July 03, 2009, 04:59:35 PM »
ahh yes you are right.. I knew there was something with Tricare..they are last unless with Medicaid..

round and round and round we go.. lol
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com