Wiki Out of State Medicaid patiients seen by physcian/office

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kguzikowski

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Muskego, Wisconsin
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Can you bill the patient for your services if the patient has out of state Medicaid plan and you are not a participating provide in the state's plan?
Provide will not be applying for In Network status for the out of state plan. If you do bill the patient and the patient does not pay, can you place the account into collections?
 
Hi,
It depends on what state you are in and what state the patient has Medicaid coverage from. The practice I bill for is in NY, but our provider saw a patient with CA Medicaid. Upon researching the CA Medicaid website I found that they will pay out of state providers for emergency care, however we still had to do a mini enrollment so that they could pay us. I know that in NY and VA you cannot send a Medicaid patient to collections even if you can't get payment from their Medicaid. Hope that helps.
 
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