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MDCR / TMHP bathroom supplies

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Trisha:
because MDCR does not cover bathroom items like a shower chair, and the patient has medicaide (MQMB) do I still bill MDCR first and get a denial then bill TMHP or do I skip MDCR and bill directly to TMHP.
Thanks for any help given. :)

Pay_My_Claims:
r u from NC? this is the only state that I know has qMB medicaid. You do know it only pays for the medicare part B premiums, therefore there is no coverage for anything else. 

Michele:
In NY, if there is a service not covered by Medicare but it is covered by Medicaid it can be billed directly to Medicaid with a code indicating non medicare covered service.  It is not necessary to bill Medicare.  But you need to check with your state's Medicaid.

Michele

blhoffman:
I think this site might be helpful. QMB, SLMB and QI are all federal programs that states can enhance with their own provisions attached. Again - states can increase the coverage - not decrease.

Where I work - I am in PA - if we are contracted with Medicare and the patient has Medicare, they are billed and once denial is received, we submit to the next carrier. Be it medicaid or not with the Medicare denial. We do Medicare first and Medicaid second. I always find I get the right answer by just calling Medicaid. Hope this helps.

http://webcache.googleusercontent.com/search?q=cache:5SAQrRL5NGgJ:www.mymedicarecommunity.org/attachment.php%3Fattachmentid%3D303%26d%3D1245782178+do+you+bill+medicare+first+or+qmb&cd=2&hl=en&ct=clnk&gl=us


http://www.medicareadvocacy.org/InfoByTopic/MedicareSavingsPrograms/MedicareSavingsProgsMain.htm

Pay_My_Claims:
Yes then again like i said if it is QMB its NOT MEDICAID, as traditional..no coverage. It just pays the Medicare premiums..therefore patient is SELF PAY!!

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