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Medicaid may deny a claim for any one of a number of reasons: submitted too late; service not covered or needs prior approval; clerical error such as procedure code doesn't match description of service, etc.
When this happens, you are responsible for the bill. However, in Illinois and perhaps other states, you may ask Medicaid to review the bill. In Illinois, you are not responsible for a bill if the provider accepted you as a Medicaid patient and Medicaid denied the claim due to the provider's error(s).
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If you were ever a Medicaid patient and lost it does the doctor have to honor the Medicaid allowed amounts?
A doctor or other provider who accepts you as a Medicaid patient (i.e., agreed to bill Medicaid for your care) is required to accept Medicaid's amount as payment in full. (However, you might have a co-pay.) In Illinois, a provider who accepts you as a Medicaid patient cannot demand payment from you if Medicaid does not pay due to the doctor's failure to bill Medicaid timely and properly. Your State might have a similar rule.
What states can you bill a Medicaid patient if the service is noncovered and you don't bill Medicaid?
In some states, you cannot bill the patient if you accepted her/him as a Medicaid patient.
What is timely filing for Medicaid denied claims?
12 months or one year
What is a medicaid claim?
A bill for a medical service or supplies that is submitted to medicaid for payment.
How does the company deal with patients who also have medicaid and medicare?
Medicaid is the payor of last resort. Therefore, bill Medicare first. Bill Medicaid for any expenses Medicare didn't cover.
If a patient does not inform us he has medicaid is he responsible for the bill?
In Illinois, if the provider did not accept the patient as a Medicaid patient, the provider may bill the patient.
Can you balance bill a Medicaid patient for out of state Medicaid?
Except for co-pays, Medicaid payment is generally considered payment in full.
How do you bill secondary Medicaid when Medicare is with an HMO?
You submit an EOB from the Medicare HMO with your Medicaid claim.
NJ Medicaid used in other countries?
Yes, if the provider is willing to bill NJ Medicaid for the service.
Will Medicaid pay for your hospital bill if the hospital waited 2 years to apply it to the bill?
Probably not, but if the hospital accepted you as a Medicaid patient you should not be liable for their delay.
Who do you contact to pay a hospital bill with medicaid?
the office
If the patient has BCBS as primary and Medicaid as secondary can you legally not accept the Medicaid and then bill the patient?
If you're an active, enrolled Medicaid provider, it is only legal in Minnesota to bill the patient for services not covered by Medicaid. If it's a covered service, they're a covered recipient and you're a covered provider, you must accept Medicaid payment as payment in full
