Medicaid Patients

By Terri Hembree posted 04-01-2011 14:34

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Good Morning.

I would like to get some opinions re: Medicaid patients. We are not a contracted provider with Medicaid. We are having a increasing number of patients coming to us and not disclosing that they have Medicaid HMO secondary until they receive a bill for a balance (co-insurance, deuctibles,etc). When they are "caught" in the office because they slip up to a nurse, they say they will pay their co-pay for their visit out of pocket, or " we just have Medicaid in case something bad happens", etc. Looking back at the sign in sheets, they have specified "NO" under Medicaid. Any suggestions on how to handle this?

Thanks

Terri Hembree,RN

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Barbara Daiker

04-06-2011 09:52

We are finding that patients increasingly do not understand their insurance coverage. It is confusing, complex, and frustrating. In the past we held the position that patients needed to be responsible for this knowledge, but recently we changed our minds. We deal with insurance all day, every day; patients do not. For this reason we are looking at ways to screen and help our patients before they arrive - when possible. You may need to do something similar. This might be a pre-registration procees, insurance verification, or something similar. It puts an expense on the front-end, but saves much more from the back end of the claims process.

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