Results 1 to 7 of 7

medicaid billing issues

  1. #1
    Default medicaid billing issues
    Clearnace Sale
    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... !!!

  4. #4
    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
    Which state are you billing for?

  6. #6
    New OLEANS, LA

  7. #7
    Pensacola , Florida
    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

Similar Threads

  1. Replies: 4
    Last Post: 04-08-2015, 10:21 AM
  2. Again--billing issues with 11056 and 11721
    By ollielooya in forum Podiatry
    Replies: 4
    Last Post: 04-17-2013, 09:44 AM
  3. Split billing two issues, same visit
    By Alisa Dinneen in forum Billing/Reimbursement
    Replies: 4
    Last Post: 08-31-2011, 04:56 PM
  4. drug shortage billing issues
    By TMUNGER in forum Hematology/Oncology
    Replies: 0
    Last Post: 08-30-2010, 03:23 PM

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?


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.