Wiki NonPar provider billing New Jersey Medical Assistance patients as self pay

[bbernal]

Is a provider who is non participating with either New Jersey Medical Assistance or Pennsylvania Medical Assistance permitted to see a patient with Medical Assistance who prefers to self-pay?

Thanks for any information.

Barbara

 

[Pferguson69]

Any Medicaid or Medi-cal patient cannot be self-pay under Federal Guidelines. They must be referred to an in-network provider. If you see the patient in error, you cannot bill the patient.

 

[csperoni]

Any Medicaid or Medi-cal patient cannot be self-pay under Federal Guidelines. They must be referred to an in-network provider. If you see the patient in error, you cannot bill the patient.

I'm not certain this is accurate. At least in NY, a non-par provider is permitted to see/treat Medicaid as self pay. They are required to properly inform the patient and a waiver is required that explains to the patient they could get covered services paid in full elsewhere.