Author Topic: Medicaid question  (Read 1015 times)

Ryanne

  • Newbie
  • *
  • Posts: 16
Medicaid question
« on: August 29, 2012, 04:45:23 PM »
Patient has Medicaid HMO as secondary insurance.   Primary insurance has been billed and paid a portion of the allowed amount (provider is not network for the primary).  Can the patient be balance-billed since provider is not enrolled in the Medicaid HMO?   (Provider is a Medicaid provider for traditional Medicaid, but not for the Medicaid HMO Amerigroup)

Michele

  • Global Moderator
  • Hero Member
  • *****
  • Posts: 4706
    • Solutions Medical Billing
Re: Medicaid question
« Reply #1 on: August 31, 2012, 01:33:26 PM »
It depends on your state laws.  In NYS you cannot bill a Medicaid Eligible patient.
Sign Up for our FREE Medical Billing Newsletter
Get a 10% discount on Medical Billing Products by using Coupon Code: 10OFF
http://www.solutions-medical-billing.com

camedbill

  • Jr. Member
  • **
  • Posts: 64
    • California Medical Billing
Re: Medicaid question
« Reply #2 on: September 03, 2012, 12:26:18 PM »
You can't bill patient here in California either.  Also, depending on how much the primary paid, if it's more than what Medicaid allowed, they're not going to pay any more anyways.