Wiki Billing medicaid primary when pt has commercial insurance

[cedwards641]

I have been told by the pediatric manager that when a child comes in for a wellness check (where they usually receive vaccines) that Medicaid or CMO insurance is billed as PRIMARY and the commercial insurance is SECONDARY. I don't believe this to be true, does anyone know if there is an exception to the rule that "medicaid is always the payer of last resort" and where can I find this if it exists. She wants to bill medicaid as primary when they come in for wellness/vfc vaccines and bill commercial when it's a sick visit.

 

[shannakk]

Medicaid is always secondary, you can call your vfc rep to verify. Commercial ins should be billed first