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Medicaid No Shows

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ARCPC9491

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Stafford, VA
I'm searching around for literature about Medicaid not allowing you to bill patients if they are no shows... and I can't seem to put my finger on it. I've seen it before... can anyone help? Thanks.
 
Here's a twist

Okay, let me throw this out there on this subject: If you can't charge Medicaid patients a no show fee, how does that affect the Medicare policy that says you can only charge a no show fee to their patients if you charge the same fee to ALL patients?


Just curious.;)

Thanks!
Jennifer, CPC
 
Good question, Jennifer~

As you stated, Medicare does allow billing for "no shows"...following certain guidelines. As someone pointed out to me, Medicare implemented this policy in 2007. Our Medicaid, on the otherhand, is notorious for having "current" (OLD!!!!) manuals...some dating back to 1999.

AR~This may be a situation where you might want to foward Medicaid a copy of Medicare's "no show" policy if your office is considering charging Medicaid patients a "no show" fee. However, this particular manual is dated April 2009...so I doubt Medicaid will change their view on this.

http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5613.pdf

One more thing...I am hearing from other coders that their states currently have guidelines in place prohibiting providers billing Medicaid patients "no show" visits. I'm sure this probably has to do with the poverty level. Excerpt from Medicaid manual--->"However, since individuals and families who are Medicaid-eligible have incomes ranging from as low as 30% of the federal poverty level up to 200% of the federal poverty level, most do not have the financial means to pay for care"
 
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I interpret the Medicare policy to be that you cannot exclusively charge only Medicare patients for no shows. "Non-Medicare" I believe does not refer to Medicaid, but other insurers.
 
ARCPC9491 said:
I'm searching around for literature about Medicaid not allowing you to bill patients if they are no shows... and I can't seem to put my finger on it. I've seen it before... can anyone help? Thanks.
Click to expand...

Keep diligent track of your No Show patients. Then discharge them for non-compliance.
 
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