tci Part B Insider - 2013 Issue 11

Reader Question: Non-Par Medicaid? Bill the Patient

Question:We have recently had an influx of patients presenting with a commercial insurance card. Then the claim gets denied, and the patients respond that they decided not to continue with commercial insurance, but rather enrolled in Medicaid. However, we don’t accept Medicaid. As a non-participating practice, we will not get paid by Medicaid for seeing these patients, and therefore I would not have seen the patient if I’d known they were on Medicaid. Can we bill the patient in this situation? Answer: Since you do not participate with Medicaid, you can charge the patients and if they...

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