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Out of State Medicaid

  1. Default Out of State Medicaid
    Medical Coding Books
    I am in Georgia and my surgeon saw two patient's in the hospital with out of state Medicaid (FL & Ill.). I have contacted these two state and have not gotten very far, they will not give you any info; such as claim status or eligibility, and basically told me that we won't get paid unless we are a PAR provider. My surgeon does not want to get contracted with them, so my question is can we bill the patient?
    Sonja Little, CPC

  2. #2
    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.

  3. Default
    Thanks! That was my opinion was as well.
    Sonja Little, CPC

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