Wiki Billing Medi/Medi patients deductible

[stonecm]

Does anyone know if it's OK to bill a patient who has Medicare primary, Medi-Cal secondary, Medicare applies service to deductible and Dr. is not contracted with Medi-cal?

I would prefer to have something in writing. The most recent information I have is from 2010:
As of 1/1/2010, you can no longer see a Medicare patient that also has Medi-Cal and collect any portion from the patient that would normally be covered by Medi-Cal, even if you are not a Medi-Cal provider.

Just wanted to know if anyone knew if this was still current or had any other information to offer. All help is greatly appreciated!

 

[pjorwin]

To my knowledge, you cannot bill any Medicaid patient for ANYTHING other than their share of cost. If the Doctor is not contracted he/she should NOT be seeing Medi/Medi patients.

 

[mitchellde]

this is correct. If your doc is not contracted with Medicaid and your patient is a Medicaid patient either primary or secondary then you are to send the patient to the contracted provider of their choice. Medicaid patients are receiving govt subsidized health care, and the govt can and does limit the access to health care these patients have. If they want to receive the assistance then they must chose a participating provider not any provider of their choosing.

 

[ajb1986]

Medicaid patients cannot be billed. The fine is upwards of $10,000.00.