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Billing a Pt instead of their Ins

  1. #11
    Milwaukee WI
    Default Medicaid contract governs
    Medical Coding Books
    If it's a covered service per Medicaid in your state, and you have signed a contract to accept Medicaid payment, then you must do so. Bill it to Medicaid, then see what your EOB says. You may not be able to bill the patient at all, but this may be one of those services where you can bill a portion to the patient.

    You said your doctor wants it "in writing." The contract the practice signed with Medicaid should address this.

    F Tessa Bartels, CPC

  2. Default Update; now what
    I actually found out yesterday that Medicaid only covers this when it's considered Medically necessary. So does this free me up to be able to bill the patient now? What about the fee, can I charge them what I want or does it have to be the same as what Medicaid pays when med necessary?
    adrianne, cpc

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