Wiki Can you bill patient?

[peterova.daniela@yahoo.com]

1. Patient was in process of getting NJ Medicaid eligibility card. He went to out of network provider’s office and paid cash. Patient found out he was Medicaid eligible for date of service (regular Medicaid).

Should patient notify provider and get refund as provider can not bill Medicaid member or our of network bill was paid correctly?

2. Patient was Medicaid eligible and came to another provider’s office with already existing Medicaid eligibility card.
He was refused service and was told he needs to go to in network provider or they may g wet fined if they accept him as a self pay. Is that correct? Can provider refuse the service?

 

[catherinetinkey@entmedicalservices.org]

If a patient chooses to go to an out of network provider that is their choice. I would have the patient sign a waiver that states they were informed that the office is out of network and that they choose to not use their insurance. If a the patient's issue was not emergent and the patient is informed that you are out of network, service can be refused.