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Thread: Out of State Medicaid Pts.

  1. #1

    Default Out of State Medicaid Pts.

    AAPC: Back to School
    My physician is located in NJ and treated a pt. in the ER. She has Medicaid of Delaware.
    Can I bill the state of Del? I have placed numerous calls to Del. Medicaid offices and no one can help.


  2. #2
    Join Date
    Apr 2007


    In my experience - State Medicaid does not cross borders. So the patient would be responsible for the bill.

  3. #3
    Join Date
    Apr 2007
    Milwaukee WI

    Default Is your physician credentialed with DE T-19?

    We are in Wisconsin, and our physicians are credentialed with Medicaid of Illinois and Michigan, in addition to Wisconsin.

    For other states, we will apply for credentialling if the charges are sufficiently high to warrant the effort.

    So, if your physician is credentialed with DE, yes, you can bill. If not, the practice management will have to decide if the charges warrent making the effort to get credentialed.

    In my experience, trying to collect from a patient covered by Medicaid is futile.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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