Medicaid is a state-administered program that covers the medical expenses
of individuals with low income. With the passage of the Obamacare Act, the
minimum eligibility for Medicaid has been set at 133% of the federal poverty
level. While most individuals would rejoice at the approval of this Act, it can
prove to be quite challenging for healthcare providers.
The Challenges of Processing for Medicaid Claim
Medicaid comes into general types -
Community Medicaid, typically given to qualified individuals who have little to
no coverage; and Medicaid nursing home coverage, which shoulders the costs
associated with staying in a nursing home.
One of the challenges that come with a Medicaid claim is the fact that
coverage qualification and policy details can vary from one state to another as
well as from one provider to the next. In here alone, a lot of money is lost if
the encoding is incorrect. By getting a proper software application, or by
having an experienced service provider, the process of checking for eligibility
for Medicaid can be simplified without necessarily compromising accuracy.
Taking Into Consideration Medicare Coverage
Some patients would have both Medicaid and Medicare coverage. If that is
the case, the information typically gets processed through Medicare without
much problem; however, you need to make sure that you have all the details
encoded correctly. Keep in mind that Medicaid makes use of a schedule of fees,
unlike Medicare. If you encoded the incorrect procedure, you might have your
patient paying more than he or she should.
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