Medicaid Billing

With all the Medicaid HMOs Medicaid billing has become very confusing. In NY many Medicaid patients have two ID cards but show only one when they come in the office. This results in many questions and incorrect billing. We recently received this question.

My question is in regards to Medicaid. I live in Nevada and one of our Dr's does a lot of Medicaid patients. They come in several forms First health (mdc)BXBS (mdc) and Smart Choice. (mdc) The cards all look the same Medicaid Nevada Medicaid Check up. Are they all billed to the same place with the same payor ID # which is in Reno? Thanks for your help. Linda

I answered her as follows

I am not extremely familiar with NV Medicaid but it sounds to me as if it is the same as here in NY. Medicaid offers Managed Care Plans in place of straight Medicaid that the patient chooses. They are offered thru other commercial insurers. Those managed care plans are billed individually to the insurance carrier that sponsors it. For example, we have a Blue Choice Option Medicaid plan which goes to BCBS, there is a United Health Care option which goes directly to UHC. Then if the patient just has straight Medicaid (didn't elect a managed care plan) the claims are billed to Medicaid. You can probably get a list of plans and addresses from the Medicaid office.

Hope that helps,