Kittyness6818
New
Hi everyone! Thanks to a rather ambitious attorney, I'm struggling with a Massachusetts PI case. I'd appreciate input from billers in MA.
The patient has MassHealth Std and opted for an $8,000 deductible when they purchased their PI insurance. The patient was recently in an auto accident, and claims have not quite yet reached the $8k threshold. The attorney has demanded that I bill MassHealth. Under the state's coordination of benefits, I believe the PI deductible must be satisfied (i.e., the patient is responsible for that amount) before Medicaid can be billed. How would you handle this? If it were not for the spicy attorney, I would continue to bill the PI carrier until I receive the benefit exhaust letter and then send the claims to Medicaid with that letter. Thoughts? Thank you!
The patient has MassHealth Std and opted for an $8,000 deductible when they purchased their PI insurance. The patient was recently in an auto accident, and claims have not quite yet reached the $8k threshold. The attorney has demanded that I bill MassHealth. Under the state's coordination of benefits, I believe the PI deductible must be satisfied (i.e., the patient is responsible for that amount) before Medicaid can be billed. How would you handle this? If it were not for the spicy attorney, I would continue to bill the PI carrier until I receive the benefit exhaust letter and then send the claims to Medicaid with that letter. Thoughts? Thank you!