Medicaid and Part B Deductible

yabadabadoo1026

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put a client on a dual advantage plan and she is claiming the doctor is wanting her to pay the 147 saying Medicaid doesn't pay that. Certainly I don't think on an advantage plan--dual or otherwise--there is that deductible BUT if on traditional Medicare with full Medicaid does Medicaid pay that 147. I was thinking Yes but the more I think about it I can see that perhaps it could be Ni--------haven't been able to find anything on the net on it yet
 
If she is on the advantage plane and it's an HMO, and the doctor is out of network, I believe she may have to pay something, but not the 147 because that is only if medicare is primary.

If she is on traditional medicare and full medicaid, then i don't believe she would have to pay the 147.
 
If a doctor is willing to see a patient with both Medicare and Medicaid he is precluded from balance billing. At least this is true in Kalifornia.

Rick
 
If a doctor is willing to see a patient with both Medicare and Medicaid he is precluded from balance billing. At least this is true in Kalifornia.

Rick

buy definition I'm not sure the 147 deductible would be a balance billing-----isn't balance billing when a doctor charges more than the medicare approved amount that's covered 100% by medicare and Medicaid?
 
buy definition I'm not sure the 147 deductible would be a balance billing-----isn't balance billing when a doctor charges more than the medicare approved amount that's covered 100% by medicare and Medicaid?

Nope. Not in this case. It would be the deductible, 20%, etc.

If you don't like the term "balance billing" in this instance then we can use "can't bill the Medicaid patient for anything not paid by insurance."

And the definition is NOT for sale. So it's probably better to have posted "By definition."

Rick
 
Nope. Not in this case. It would be the deductible, 20%, etc.

If you don't like the term "balance billing" in this instance then we can use "can't bill the Medicaid patient for anything not paid by insurance."

And the definition is NOT for sale. So it's probably better to have posted "By definition."

Rick

that was clearly a typo cause I know better than that
 
I just ran into this with a UHC customer. The computer in the front end of UHC (from what I am told) shows the customer as having full medicaid. The claims department computer is not showing her as having Medicaid at all therefore she is being charged the $147.
We haven't figured out how to solve this issue yet.
 
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