I have occasionally come across patients who, somehow & some way, have active Medicaid in two states. For example, they have active Medicaid in Arizona while being active with Medi-Cal at the same time. I've also seen one state have a COB with another state (ex. Nevada Medicaid shows that they're secondary to UT Medicaid). I usually bill the state Medicaid that the patient has on file as their address; using the example from before, if the patient's address is in CA I would bill Medi-Cal but if it was in AZ I would bill AHCCCS. However, in an instance where the first Medicaid denies, how would you handle it? Would you submit the claims to the other state Medicaid or write them off (depending on the denial)? If you did bill the other state Medicaid, would you submit them as primary or secondary? This is a super rare thing that I have seen only a few times, but I wanted to see everyone's thoughts on how they would handle it.