Obstacle for Duals
- Thread starter somarco
- Start date
Put them on a coordinate plan, the sign make no sense they don't bill Medicare the bill the insurance company, in this case it sounds like that Atlanta plan is not a coordinate plan
straightnochaser
Guru
- 854
It’s illegal to bill someone who is QMB so I wish them luck with that.
- Thread starter
- #4
GA rules for Medicaid patients . . .
Remember, enrolling in Medicaid as an OPR provider:
• Does not obligate you to see Medicaid patients;
• Does not mean you will be listed as a Medicaid provider for patient assignment or referral;
• Does not require an annual renewal;
• Allows you to continue to see Medicaid patients without billing the Medicaid program if you so choose
Remember, enrolling in Medicaid as an OPR provider:
• Does not obligate you to see Medicaid patients;
• Does not mean you will be listed as a Medicaid provider for patient assignment or referral;
• Does not require an annual renewal;
• Allows you to continue to see Medicaid patients without billing the Medicaid program if you so choose
Special Agent
Guru
- 380
Not an issue since they are in network with the big MA plans as most blood sucking endocrinologists are .If i sign someone up for DSNP PPO i explain that if they go out of network and the provider doesn't bill medicaid they will be responsible for cost share.Besides most dual eligible don't pay their bills anyway.
- Thread starter
- #7
They do not take duels they are out of network
Not sure what is missing?
I have some duels, but really there is only one type of plan this even matters with that I care to sell
Most duels are HMO Plans as the HMO plans give much more benefits
On occasion there is one that wants to have less benefits to be on UHC PPO duel so they can go do out of network doctor
but they understand really really well if the doc does not take Medicaid they will pay the out of network of 40%
but for the rest they are all HMO with more grocery and utility money and would end up in a place that does not take it
Not sure what is missing?
I have some duels, but really there is only one type of plan this even matters with that I care to sell
Most duels are HMO Plans as the HMO plans give much more benefits
On occasion there is one that wants to have less benefits to be on UHC PPO duel so they can go do out of network doctor
but they understand really really well if the doc does not take Medicaid they will pay the out of network of 40%
but for the rest they are all HMO with more grocery and utility money and would end up in a place that does not take it
- Thread starter
- #9
@vic120 thank you for your detailed response.
As indicated, this is not my market and not one I care to pursue.
I am getting accustomed to seeing a growing list of MA plans that the doctor offices no longer take, but this one caught me off guard.
Again, not my market, but curious about the feedback.
As indicated, this is not my market and not one I care to pursue.
I am getting accustomed to seeing a growing list of MA plans that the doctor offices no longer take, but this one caught me off guard.
Again, not my market, but curious about the feedback.
Not my market either but I get a few from time to time.
I see those signs too but I don't bother to read them that much.
I just throw down my little red white and blue card and keep on trucking.
Same thing coming out. No stopping at the settle up window.
I love that card.
Similar threads
