Author Topic: Billing Contractual write off to Texas Medicaid  (Read 1190 times)

EpicMed

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Billing Contractual write off to Texas Medicaid
« on: August 24, 2012, 01:47:01 PM »
Can you bill and be reimbursed for the commercial contractual write off if the Medicaid reimbursement is more than the contractual agreement with the commercial payer

Michele

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Re: Billing Contractual write off to Texas Medicaid
« Reply #1 on: August 27, 2012, 06:58:58 AM »
I'm not sure I've got the question.  I'm assuming the Medicaid is secondary to the commercial, and are you asking if you can bill Medicaid for the contractual adjustment?  In my experience with TX Medicaid they pay based on the remaining amount after the primary pays, but I bill the same charges that I bill to the primary, with the payment information so that they determine what will be allowed.
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LASHUNDA

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Re: Billing Contractual write off to Texas Medicaid
« Reply #2 on: August 29, 2012, 10:18:56 AM »
Remember that TX Medicaid only pays up to the TX Medicaid allowable.  Therefore, if the primary paid more than the TX Medicaid allowable then most likely TX Medicaid will not pay anything.  It should be written in the primary plan agreement/contract that was executed with the physicians that they are not allowed to bill the write amount.  That's why it's called a contractual adjustment.