Wiki Medicaid- that's not right!!?

[Pbhatt1]

Medicaid copay is $2.00.If Medicaid is not paying for venipuncture then is it ok to charge patient full uninsured allowable fees? Help!!!

 

[mitchellde]

probably not but it does depend on the type of Medicaid and state specific rules. Also there is the question as why they are not paying for it, and finally what does the EOB indicate.

 

[CodingKing]

It sound like you are a medicaid participating provider. You cannot bill Medicaid member even for denied services.

 

[Pbhatt1]

Thanks for your reply....

 

[Pbhatt1]

Again, thank you!!!??What if services are not billed and there is no EOB?

 

[CodingKing]

What if services are not billed and there is no EOB?

It doesn't matter. Its treated the same, its against the law for you to bill the patient.

 

[Pbhatt1]

?I cannot read your message. Sorry!!!

 

[mitchellde]

If the patient is Medicaid then you cannot elect to not bill the claim and then bill the patient. Medicaid gets to dictate if there will be any patient out of pocket amount. Not all Medicaid plans are the same . Some are spend down , some are HMO , some are straight Medicaid. No matter what type if they are Medicaid you must bill Medicaid and the EOB will tell you what if any amount is patient responsibility, if it is $2 then you may collect $2 from the patient. That is they way it works.

 

[Pbhatt1]

Thank you Debra for your reply. The problem is all facilities does not accept the right method.

 

[mitchellde]

I am not sure what you are referring to.

 

[Pbhatt1]

I got my answer.