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NC MEDICAID

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Sabrina:
HELLO,

Does anybody know where to find the rules for NC Medicaid regarding %.  ??? 

Pay_My_Claims:
%?? do you mean how much a billing service can charge? I can send you the link to the NC Medicaid webisite

http://www.dhhs.state.nc.us/dma/

Sabrina:
Hi, Pay My Claims ;D

I am aware of the NC website. I am trying to find can i charge a % of what is collected not billed on NC Medicaid. If not than I would have to charge per claim but it would be based of what is collected to determine fee at time of payment. I would have to word that in my contract. Of course, it would be explained to the provider.  Just wondering about the %.  Thanks!

Pay_My_Claims:
I'm not sure Sabrina, but I think even with Medicaid it all falls under fee splitting & kick backs. If I find anything directed specifically to NC Medicaid, i will surely post it. Even charging per claim, you have to be cautious to go within the normal rate or it can be considered a "kick back"

Michele:
You can actually get around it in the wording of your contract by stating something like 

"charge a flat fee to be determined monthly based upon receivables from previous months"

Or some variation.  Crazy to just have to reword things to get paid!  :)

Michele

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