Working with Medicaid - covered under their Medicaid plan,...

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Medicaid is an insurance program for low-income and for the people that provide health-related services for the individuals who qualify. Medicaid is funded by the Federal, all fifty states, and the District of Columbia. People who are Medicaid eligible are those with low incomes who receive financial assistance under Temporary Assistance for Needy Families (TANF), those whose are eligible for TANF but who do not receive financial assistance, kids under six years of age or whose family based money is below 133% of the poverty level, woman who are pregnant with a family income that is below 133% of the poverty level (coverage limited to pregnancy-related medical care), newborns born to Medicaid-eligible pregnant women, adults who are age sixty-five and over, legally blind, or totally disabled and who receive Supplemental Security Income (SSI), and a small handful of low-income Medicare recipients. A medical provider can only bill a Medicaid patient directly for service if it is known beforehand that the service is not
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Unformatted text preview: covered under their Medicaid plan, if it is established in a written policy for billing noncovered services for both patients and not just Medicaid, if it is known in advance the amount to be charged for any specific procedure and signs a document stating there are joining to pay it. Implications of simultaneous federal and state involvement in the insurance process would be duplication of effort - which is costly - and lack of communication. Also implications could be state regulations could conflict with the Federal regulations, complexity is increased due to satisfying the requirements of two regulatory bodies, cost of compliance is greater because there would be two regulating bodies, product innovations are inhibited due to excessive regulation, and regulatory goals of the States may be different than the Federal goals....
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This note was uploaded on 12/14/2011 for the course AXIA OF UO AAAA0GOT71 taught by Professor Gaylordvanalstine during the Spring '09 term at University of Phoenix.

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