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How much will I get paid if I dont contract with an MCO but provide services to an MCO member?

April 26, 2017contract mco paid Services

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How much will I get paid if I dont contract with an MCO but provide services to an MCO member?

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MCOs must pay out-of-network providers at the lesser of the providers usual and customary charges or 100 percent of the Medicaid rate, unless they have a different agreement with the provider. Out-of-network services, except for emergency services, require prior authorization from the MCO.