Question

If a patient presents a Medicaid card months after treatment has been rendered, am I required to submit the claim to Medicaid?

Q: If Medicaid coverage is made retroactive, do I have to submit the claim for the treatment or balance owed? For example, if the patient becomes eligible for Medicaid due to loss of income and is approved for healthcare services received previously, do I have to submit a claim? 

A: Yes, as long as the provider is notified of the Medicaid coverage within the timely filing period (typically twelve months). The provider should then immediately submit the Medicaid claim. Once payment has been received, any payment the patient has previously made must be reimbursed to the patient. 

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