Billing Medicaid vs Selfpay

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Hello, Our physicians are in the process of changing their age restriction for their Medicaid contract to only see patients ages 0-21. They will not be keeping their established patients 22 and older so we have a couple of patients who are willing to self pay just to keep seeing the doctor. Would it be illegal not only on the doctors part but also the patient to self pay when they have Medicaid or another Medicaid HMO plan? Thank you

You cannot have a self pay Medicaid patient. They have received access to Medicaid coverage based on the fact that they told Medicaid they could not afford to pay. They are receiving state funded coverage and the state dies get to dictate the providers they are allowed to see. Sorry but you do not want to do this, the patient can seek a new provider or drop Medicaid



Billing Medicaid vs Selfpay