medicaid billing issues

codedog

True Blue
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959
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NEW ORLEANS
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does anyone have any major issues when billing medicaid? Example denials for PCP referrals, billing prov not on attending prov record on dos. Any feedback will help.:confused:
 

drakena74

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Local Chapter Officer
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Fullerton, CA
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aaauuugghhh!

I live in southern CA and Medi-Cal (medicaid) is really horrible about paying anything. In my specialty (ophthalmology) we mostly see medi/medi patients. We end up writing off the all the exams and diagnostic procedures. The only thing they acctually pay us decently for is cataract surgery.
 

elenax

Expert
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337
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Stuart
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billing medicaid

I work for an ASC and I also have problems getting paid by medicaid. I am getting a denial on all my claims "0297" which indicates that the provider is not valid. I recently spoke with the Medicaid provider services and I was informed that the problem was on their end and that their system was rejecting the claims in error. This past week I started getting paid for some of those claims.

hope this give you a clue...:) !!!
 

bwoz

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With MA medicaid, the PCC denial is usually used when the recipient has a PCC on file, and the procedure requires an authorization from them for the services. We simply call the PCC and advise them of the visit (preferably beforehand if possible) and if they ok the visit, they give us their PCC number to resub with. With the billing provider issues, I'd call them to get the specific reason and make sure they have your provider in their system correctly in relation to NPI, tax id, etc. Hope that helps!
 

Justarose

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Pensacola , Florida
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Medicaid billing issues ?

Trent are you still having problems with Medicaid billing ?

Let me know - I have gone through it all and have lots of reasons -

I won't take the time now to list unless you need the info ;)
 
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