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Thread: Home Health Care

  1. #1

    Default Home Health Care

    AAPC: Back to School
    I am in Ohio and I am new to home health care billing although I have an extensive billing background. In my experience Medicaid is always considered the payor of last resort. However, I am being told here through home care a patient who has Medicare/Medicaid can be billed directly through Medicaid. When Medicaid is billed though of course they are denying for Medicare primary. Does anyone have any information or insight on this? I have read and understand that in order for Medicare to pay for home health care the patient has to be homebound or meet other criteria so if they do not and Medicaid is billed, how to get around the Medicare primary denial?

  2. #2
    Join Date
    Apr 2007


    I do Home Health billing and I always had a hard time understanding that also. I have never got denied by Medicaid when billing them directly. Why is unsure to me but they do pay even though some of the Medicaid pt have Medicare primary but do not meet Medicares guidlines. I use to arguee with my nurses and supervisor about this and they assure me it works, and it has so far.

  3. #3
    Join Date
    Apr 2007


    I just came back from a Ohio Medicaid Billing Training last week. The question was asked and the Gentleman doing the training said that since the patient is not homebound under medicare you bill Medicaid for the Home Health service.

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