Wiki Balance billing DSHS/Medicaid patients.

[l1ttle_0ne]

Our boss is stating that in other states (we are in Washington) practices can balance bill patients who have DSHS/Medicaid. So in other word's if a patient has medicare primary , and medicare allow's $500.00 on a procedure, after DSHS/Medicaid (secondary) pays what they will. You instead of writing off the balance, can bill the patient for the rest of the Medicare allowable. This to my knowledge is illegal. He says that that may be in the state of Washington. But not in other states. Does anyone know what he is talking about???

 

[cldavenport]

In all the practices/states I've worked in, we never billed the patient after Medicaid has paid. Up until 2010, I was working in Washington State. Once Medicaid paid, the balance was adjusted off the account. We never balance billed the patient.

 

[capricew]

If you are contracted with your states Medicaid program, you cannot bill the patient after Medicaid pays unless a portion of the bill has been designated as patient responsibility on the EOB.
But, if the eob states the balance is a contractual write-off then you absolutely cannot bill the patient.