I do not know if there is anything written on this, but in my experience, if the patient has medicaid as secondary - you will need to bill medicaid for this copay. In my state, NH, medicaid does pay if the primary payer amount is more than what medicaid would pay, therefore the $50 would be adjusted off per medicaid. But Medicaid does need to be billed before any adjustments.
I hope this helps!
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