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Read About Billing For Medicaid

Creating claims for Medicaid can be even more difficult than creating claims for Medicare. Because Medicaid varies state-by-state, so do its regulations and billing requirements.

As such, the claim forms and formats the biller must use will change by state. It’s up to the biller to check with their state’s Medicaid program to learn what forms and protocols the state follows. You can also visit snf-solutions.com for more information about Medicare billing.

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In general, the medical biller creates claims. The claim must contain the proper information about the place of service, the NPI, the procedures performed and the diagnoses listed. The claim must also, of course, list the price of the procedures.

Be aware when billing for Medicaid that many Medicaid programs cover a larger number of medical services than Medicare, which means that the program has fewer exceptions.

One final note: Medicaid is the last payer to be billed for a service. That is, if a payer has an insurance plan, that plan should be billed before Medicaid.

In general, it’s much too difficult to describe the full process of billing Medicaid without going into an in-depth description of specific state programs. If a biller has to use manual forms to bill Medicare, a few complications can arise.