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Vaida Posted 3 Year(s) ago

Hi. If Medicare provider does not participate with Medicaid and patient has Medicare as a primary and Medicaid as a secondary insurance… Would this provider be able to charge 20% coinsurance after Medicare process claims or it's always a rule not to charge patients that have a Medicare/Medicaid combo?
Provider is located in Florida.
Thank you!

SuperCoder Posted 3 Year(s) ago

Thanks for your question. Your provider should not charge the Qualified Medicare Beneficiary or QMB a Medicare coinsurance or deductible even if you do not accept Medicaid as a payer. Please see the attached CMS links for their answer on this issue. Hope this helps.

http://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/MedicareMedicaidGeneralInformation.html

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE1128.pdf

Posted by Vaida, 3 Year(s). There are 2 posts. The latest reply is from SuperCoder.

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