We bill the patient. Because they are out of state it is their responsibility to arrange payment through their caseworkers. We do not see the patient without first informing them we are not participating with their state's medicaid and that they are considered self pay and they are expected to pay for services that day, or they may go to the er. They usually go to the ER because they won't have to pay for the services. It is really difficult billing a Medicaid patient out of state because you don't usually get a correct address, phone etc.
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