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Medicaid

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Anand:

--- Quote from: dekenn on August 10, 2010, 02:44:36 PM ---Here's another one of those secondary questions.. Sorry, I seem to have a lot of them lately   :)

We have a patient that had surgery, 4 separate procedures.
Medicare is her primary, and they allowed and paid their portion for all 4 procedures.
Horizon NJ Health (managed medicaid program) is her secondary... According to their policy, they pay 100% of first procedure, 50% of second procedure and 25% of third procedure. No other procedures will be paid. period. doesn't matter if it was processed by medicare and that it's a legitimate bill.
So, they only covered half of what medicare said was patient responsibility for the 3rd procedure and none for the 4th.
Can I bill the patient????   ???

--- End quote ---
If that's what the pt's plan say, i think pt can be billed.

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