Wiki Refraction Medicare with Medicaid Secondary

[edmedbilling]

Good Morning,
I know that Medicare does not pay for refraction. I am in Washington State.
Background: One problem we were having with medicare is that we'd send over a claim with medical and vision dx on it and they would deny the whole claim as vision. So we started splitting the claims. Billing Medical separate from the Refraction.

Medicaid. Once the claim gets to medicaid and they deny the claim we've been writing it off. Should we write it off? Can we bill the patient? My thinking is yes since it is a non covered service.

What do you do in your offices when patients have both Medicare and Medicaid with a Medical /Vision visit? Or other insurance and medicaid secondary?

Thanks for any light you can shed!

 

[michellepilcher]

In Alaska you can bill any non covered service (such as the refraction) to a Medicaid patient IF the patient was told in advance it wasn't covered and agreed to pay for it. It would need to be documented of course, and probably paid for at the time of service if you traditionally do not bill medicaid patient's.