Wiki Billing patients with Medicaid secondary

[CatchTheWind]

We participate with Medicare, but not Medicaid. I know that we are therefore required to write off the deductible and co-insurance for patients who are "fully-qualified" (QMB) dual-eligibles. Does this rule apply also to patients who have a Medicare Advantage plan rather than traditional Medicare?

 

[MarcusM]

Good question. Through personal experience in dealing with Medicaid clients, even if you are allowed to bill them, they don't have funds to pay so it gets written off to bad debt after spending the time, expense and effort to try to collect.

 

[mhstrauss]

We participate with Medicare, but not Medicaid. I know that we are therefore required to write off the deductible and co-insurance for patients who are "fully-qualified" (QMB) dual-eligibles. Does this rule apply also to patients who have a Medicare Advantage plan rather than traditional Medicare?

I don't know where to find this in writing, but I have been told that yes, you treat dual-qualified patients that have Medicare Advantage plans the same as you treat traditional Medicare patients...that is the guideline we follow in my clinic. If I can find a solid reference, I will post here for you.

 

[mhstrauss]

Ok, that was almost TOO easy

Here ya go!!

http://www.cms.gov/Outreach-and-Edu..._Beneficiaries_Dual_Eligibles_At_a_Glance.pdf

 

[CatchTheWind]

Thanks Meagan.

So that settles it - no billing to QMBs even if they have a Medicare Advantage plan.