Wiki Backdated Medicare

[wgmarrs]

A patient has WV Medicaid and our agency has billed and been reimbursed by Medicaid for services rendered. The patient comes in to the office today and we learn he has received backdated Medicare coverage, with a start date of January 1st of this year. He feels we should reimburse Medicaid for all services paid since January 1st - and then bill Medicare. My feeling is that we only need to bill Medicare primary moving forward from our notification, and that no reimbursement for services during the backdate period need occur. Do I need to rethink my stance?

 

[thomas7331]

The patient is correct, you'll need to correct the billing for the period of time for which the coverage changed. If you don't initiate it on your end, most likely the Medicaid plan will eventually try to recover the payments anyway. To avoid problems with timely filing, it's in your best interest to go ahead and file all the claims to Medicare sooner rather than later.