Faith asked in Business & FinanceInsurance · 4 weeks ago

What do you call it when a provider bills wrong Medicaid but not ever medicare?

A provider of medical equipment is given both Medicaid and Medicare Insurance information for Nebulizer. They bill old Medicaid Policy not in effect, but don't bother with Medicare.

Update:

The current Medicaid/Medicare provided, but old policy number for Medicaid used, but never Medicare. What do you call this?

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  • Anonymous
    4 weeks ago

    That's just a mistake; it happens all the time. Just ask them to bill Medicare when they come to you for payment.

    P.S. It's called Coordination of Benefits, or COB. Medicaid is a "payer of last resort." That means that they only pay after everyone else has. If the Medicaid policy were active, the provider's claim would have been flagged and rejected with a message indicating that there was other insurance. Since the policy was inactive, the claim likely never got flagged. Most providers know to bill Medicaid last. It could be because of something as simple as a temp working in billing that day.

    Source(s): I work for a major insurance company.
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