Michigan Medicaid Spend down

Leandra

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Does anyone have clear information/understanding on exactly how the Michigan Medicaid Spend down works? I have searched the MDCH website without much luck. Our office understands the spend down to work like this: a patient comes to the doctor, shows as spend down in CHAMPS so we charge pt pay rates, the pt turns in our bill (and any others) to meet their required spend down amount and their caseworker makes the Medicaid active AS OF THE DATE the receipts are turned in and accepted - they do not retro the effective date. I have a patient that has called numerous times trying to tell me that in her case the effective date will be retroactive to the beginning of the month (whatever month that may be). This pt wants an appt but doesn't want to pay at the time. I have asked the pt to get a letter from her caseworker stating that the effective date will be made retro but I have not seen one as of yet. I was curious how other offices handle these types of situations.

Thanks for any input and HAPPY FRIDAY!
 

JMeggett

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Does anyone have clear information/understanding on exactly how the Michigan Medicaid Spend down works? I have searched the MDCH website without much luck. Our office understands the spend down to work like this: a patient comes to the doctor, shows as spend down in CHAMPS so we charge pt pay rates, the pt turns in our bill (and any others) to meet their required spend down amount and their caseworker makes the Medicaid active AS OF THE DATE the receipts are turned in and accepted - they do not retro the effective date. I have a patient that has called numerous times trying to tell me that in her case the effective date will be retroactive to the beginning of the month (whatever month that may be). This pt wants an appt but doesn't want to pay at the time. I have asked the pt to get a letter from her caseworker stating that the effective date will be made retro but I have not seen one as of yet. I was curious how other offices handle these types of situations.

Thanks for any input and HAPPY FRIDAY!
Hey Leandra ~ I'm in Washington State but that is exactly how our Medicaid Spend down works also. And you told the patient exactly what I would have..."bring us a letter stating that from your caseworker and I'll be happy to oblige." It can be easy to be caught in a tricky situation where it really was patient's responsibility and then we never see any payment for the visit...so explaining that we need this information from the caseworker to protect our office AND to protect the patient from future financial problems is really important. OR give patient the option of paying up front and potentially having a credit due back to them after Medicaid pays. Not fun.
Jenna
 
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