tci Medicare Compliance & Reimbursement - 2009 Issue 16
COLLECTION: Get a Helping Hand From The State to Collect Copays
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Article Overview
This article explains how state Medicaid policies can affect whether practices are able to collect Medicare copays and other cost-sharing amounts from low-income patients. It focuses on dual-eligible assistance programs, differences among states, and why providers should verify local Medicaid procedures before assuming cost sharing will be paid. The piece is aimed at medical practices, billing staff, and compliance professionals who work with Medicare and Medicaid patients.
Why This Topic Matters
State policy can determine whether a practice can recover certain patient cost-sharing amounts, so understanding the available assistance programs and local Medicaid rules helps billing teams set expectations and avoid missed collections.
What You Will Learn
- How state Medicaid policy can affect collection of Medicare-related patient cost sharing.
- The general differences among the main dual-eligible assistance programs.
- Why eligibility for one program does not necessarily mean the same result across all states.
- Why practices should contact their state Medicaid agency to confirm local procedures.
Who Should Read This
- Medical billing staff
- Practice managers
- Revenue cycle teams
- Compliance professionals
- Healthcare administrators
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