Q. I recently took care of an unassigned patient admitted through the emergency room, as required by law. The patient is applying for Medicaid, but Medicaid says it will not pay me because I am not a Medicaid participant. However, I am not allowed to bill the patient, either. Do I have a recourse? How can I avoid this dilemma in the future?
A. You — and any physician who does hospital work or is on call — can avoid this situation by obtaining a Medicaid number to use just in such cases. Having a Medicaid number will not obligate you to take other Medicaid patients.
As for your current case, you can apply for a Medicaid number, then go ahead and submit the claim. It will be denied, but you can appeal this decision within the 180-day appeal deadline.
Do you have questions like this one? Search the FAQs on the TMA website for information on practice management, legal issues, and more. On the FAQs page, you also can submit a question to TMA staff experts, who will answer you by e-mail within two business days.
Content reviewed: 3/22/2007
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