Wiki Medicaid and Billing the Patient

[SymphonySamantha88]

I am new to the insurance world and I was wondering... if Medicaid states that a patient has a coinsurance or a copay is the patient responsible?

Also, if Medicaid does not pay for something (denies it) can we bill the patient subsequently? Or is an ABN required?

Thanks in advance!

 

[dclark7]

Some states require co-pays for Medicaid patients. If the EOB states that the patient has a co-pay/co-insurance then yes the patient is responsible to pay that amount. If you provide a non-covered service then you must tell the patient in writing in advance that the service is non-covered and how much it will cost them. Check out your states Medicaid web-site and billing instructions for more information.