Is the client responsible for services provided before information is given to the provider or services provided before the provider determines the client has Medicaid?
Services provided prior to a consumer being determined eligible for Medicaid or prior to the provider learning of Medicaid eligibility may be reimbursable with a retroactive prior authorization request. (405 IAC 5-3-9) Please note it is also the resposibility of the provider to regularly check Medicaid eligibility for consumers they serve. This includes consumers new to the system as well as those who are already Medicaid eligible. Please see Bulletin BT201015 at http://www.indianamedicaid.com/ihcp/index.asp for details related to Retroactive MRO Prior Authorization requests.
Related Questions
- Who is responsible for payment of professional services when a medical assistance client is treated in the hospital and the provider does not have a Core Provider Agreement?
- How can a provider enroll to receive reimbursement for child care services provided to a family?
- How can Medicaid be used to finance the long-term care services provided to American Indians?
