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Question about Medicare/Medicaid

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Michele:
Yes, provider could be in trouble! 

Claudelia:
I have a client who is a Medicare provider but not a Medi-Cal provider.  I called Medi-Cal and asked if we could charge the patient for copays and deductibles and they gave me a resounding "NO"!!  The copay issue is one thing, but the deductible just doesn't make sense to me.  I suppose if I called them again I'd get another answer???

DMK:
If the service provided is a service covered by Medi-Cal, they can not collect deductible or co-pay.  The doctor KNOWINGLY accepted a Medi-Cal client (and they get to make that choice) that means they only get what's covered by Medicare and they have to eat the rest.  If they want the extra Medi-Cal money (and usually there is no extra, Medicare almost always pays more) then they must be a Medi-Cal provider and do all the paperwork.

If the service provided is NOT covered by Medi-Cal (Chiropractic for instance) then they MUST collect the deductibles and co-pays otherwise it's considered a kick-back.  I suppose you could have financial hardship papers on file, but the co-pay is relatively small and if you let them know up front, they should expect to pay.

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