Medicaid is different in every state and if you are a Medicaid provider for Florida then they should have provided you with a resource for information, whether that is a website or phone number. However I did find in one state the reason a provider was not being paid was they were using the wrong place of service. The physician was seeing Medicaid HMO patients in the outpatient setting and the billing service was using place of service 11. So while the hospital was a covered entity the physician was not as long they were using 11 for place of service, when they changed to the correct POS of 22 he was paid fine. My point being there may be something like this that is incorrectly entered on the claim, it only takes one little thing for Mediciad to turn the entire claim back as unpaid.
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