Wiki Medicaid Patients

[slenert]

Our office has a patient who was treated in the past for pain management and had no fault insurance, well now patient's insurance exhausted and only has Keystone First Medicaid the office doesn't accept that insurance so the patient wants to treat with doctor and pay out of pocket. My question is: is that allowed by law, I say no but would like to get some input from others in the field.

 

[SamanthaJan31$]

According to the Department of Financial Services it depends on the contractual arrangement the provider has with the patient/ and or insurer. In the absence of any other available coverage after exhaustion of the no-fault benefits, there is no obstruction to the health care provider's ability to bill the patient directly. Payment of fees for services rendered after the exhaustion of no fault benefits are still subject to the fee schedule limitations established pursuant to NY Ins. Law.

http://www.dfs.ny.gov/insurance/ogco2008/rg080728.htm

Hope this helps,