Here is the story - I work in a doctors office, and in the mid fall of last year, we saw a patient who came in with a Medicaid HMO card. We took that plan, but not straight Medicaid, so we saw the patient. The girl who runs eligibility in our office clearly never called the Medicaid HMO, because it turns out the patient had term'd with the Medicaid HMO about 2 weeks before the procedure was done, and only had straight Medicaid. So we did a procedure on this woman when she was a straight Medicaid patient, unbeknownst to us (or her, she didn't know the HMO was term-ing before the surgery). We don't take straight Medicaid, and the doctor I work for wants to bill her, as we didn't know she had straight Medicaid only. I spoke to the patient who stated it's not legal in NY to bill a Medicaid patient. Are we just out of luck or can we go after her? All the reading I've been doing on it doesn't seem totally clear......
Thanks so much for your help!