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medicaid billing issues

  1. #1
    Location
    NEW ORLEANS
    Posts
    956
    Default medicaid billing issues
    Medical Coding Books
    does anyone have any major issues when billing medicaid? Example denials for PCP referrals, billing prov not on attending prov record on dos. Any feedback will help.

  2. #2
    Unhappy aaauuugghhh!
    I live in southern CA and Medi-Cal (medicaid) is really horrible about paying anything. In my specialty (ophthalmology) we mostly see medi/medi patients. We end up writing off the all the exams and diagnostic procedures. The only thing they acctually pay us decently for is cataract surgery.
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

  3. #3
    Default billing medicaid
    I work for an ASC and I also have problems getting paid by medicaid. I am getting a denial on all my claims "0297" which indicates that the provider is not valid. I recently spoke with the Medicaid provider services and I was informed that the problem was on their end and that their system was rejecting the claims in error. This past week I started getting paid for some of those claims.

    hope this give you a clue... !!!
    NoRaX

  4. #4
    Default
    With MA medicaid, the PCC denial is usually used when the recipient has a PCC on file, and the procedure requires an authorization from them for the services. We simply call the PCC and advise them of the visit (preferably beforehand if possible) and if they ok the visit, they give us their PCC number to resub with. With the billing provider issues, I'd call them to get the specific reason and make sure they have your provider in their system correctly in relation to NPI, tax id, etc. Hope that helps!

  5. #5
    Default
    Which state are you billing for?

  6. #6
    Location
    NEW ORLEANS
    Posts
    956
    Default
    New OLEANS, LA

  7. #7
    Location
    Pensacola , Florida
    Posts
    122
    Question Medicaid billing issues ?
    Trent are you still having problems with Medicaid billing ?

    Let me know - I have gone through it all and have lots of reasons -

    I won't take the time now to list unless you need the info

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