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Thread: New Urgent Care Center-Need answers and advice

  1. #1

    Default New Urgent Care Center-Need answers and advice

    AAPC: Back to School
    I have 2 questions about a new urgent care center

    First question: The physician has not been approved for Medicaid as of yet but he is seeing Medicaid patients, so the billing department is holding these claims until he get is Medicaid number. Will they be able to bill these claims dated before he was issued his Medicaid number? Any guideline on this in writing? I'm in Georgia.

    Second question: Medicaid is coming to the site for an on-site visit, is this part of the Medicaid provider enrollment process? What will they be looking for/ reviewing? What do I need to have in place for this visit?

    anyone ever had this done before?


  2. #2


    Billing - He will only get paid/be able to bill from his effective date with Medicaid.

    As for the on site visit - did you get a letter?? If they are looking for something in particular they should have sent something.

  3. #3


    I have experienced this problem and the clinic lost money because the Medicaid application
    was not approved. This can be a big financial loss to the clinic because there can be delays
    in getting an application approved for a provider. I know that the clinic just wants to meet the patient care needs. But the bottom line is it is not worth the risk.

  4. #4
    Join Date
    Apr 2007

    Unhappy Urgent Care Ctr

    I am in agreement with the last two writers. A lot of money has just left your practice. Medicaid will not back bill they will only reimburse from the effective date that is on your acceptance letter. I would stop seeing those pt's until you get your effective date. I hate to be the barrer of bad news.
    [I]Elizabeth Comma-Watson, CPC
    Billing/Coding Specialist
    Greensboro, NC 27455-2601

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