Results 1 to 2 of 2

Michigan Medicaid Spend down

  1. #1
    Default Michigan Medicaid Spend down
    Medical Coding Books
    Does anyone have clear information/understanding on exactly how the Michigan Medicaid Spend down works? I have searched the MDCH website without much luck. Our office understands the spend down to work like this: a patient comes to the doctor, shows as spend down in CHAMPS so we charge pt pay rates, the pt turns in our bill (and any others) to meet their required spend down amount and their caseworker makes the Medicaid active AS OF THE DATE the receipts are turned in and accepted - they do not retro the effective date. I have a patient that has called numerous times trying to tell me that in her case the effective date will be retroactive to the beginning of the month (whatever month that may be). This pt wants an appt but doesn't want to pay at the time. I have asked the pt to get a letter from her caseworker stating that the effective date will be made retro but I have not seen one as of yet. I was curious how other offices handle these types of situations.

    Thanks for any input and HAPPY FRIDAY!
    Leandra Tufts, CPC, CEMC, COBGC

  2. Default
    Quote Originally Posted by Leandra View Post
    Does anyone have clear information/understanding on exactly how the Michigan Medicaid Spend down works? I have searched the MDCH website without much luck. Our office understands the spend down to work like this: a patient comes to the doctor, shows as spend down in CHAMPS so we charge pt pay rates, the pt turns in our bill (and any others) to meet their required spend down amount and their caseworker makes the Medicaid active AS OF THE DATE the receipts are turned in and accepted - they do not retro the effective date. I have a patient that has called numerous times trying to tell me that in her case the effective date will be retroactive to the beginning of the month (whatever month that may be). This pt wants an appt but doesn't want to pay at the time. I have asked the pt to get a letter from her caseworker stating that the effective date will be made retro but I have not seen one as of yet. I was curious how other offices handle these types of situations.

    Thanks for any input and HAPPY FRIDAY!
    Hey Leandra ~ I'm in Washington State but that is exactly how our Medicaid Spend down works also. And you told the patient exactly what I would have..."bring us a letter stating that from your caseworker and I'll be happy to oblige." It can be easy to be caught in a tricky situation where it really was patient's responsibility and then we never see any payment for the visit...so explaining that we need this information from the caseworker to protect our office AND to protect the patient from future financial problems is really important. OR give patient the option of paying up front and potentially having a credit due back to them after Medicaid pays. Not fun.
    Jenna

Similar Threads

  1. Replies: 4
    Last Post: 04-08-2015, 11:21 AM
  2. Rhogam injection for michigan medicaid patient
    By medicalbiller1964 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 11-19-2010, 10:37 AM
  3. Podiatry for Michigan Medicaid
    By sphillips79 in forum Podiatry
    Replies: 6
    Last Post: 06-09-2009, 08:34 PM
  4. Michigan Medicaid
    By oreyeszwirn in forum Emergency Department
    Replies: 3
    Last Post: 02-11-2009, 01:24 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.