Enter your email address:

Delivered by FeedBurner

The Payor of Last Resort

Remember one thing Medicaid is always the last payor.
If third party liability exists, then Medicaid is always the payor of last resort. This simply means that Medicaid always pays last where other insurance is present.

Whenever you receive a Medicaid denial advising you to bill the primary insurance, it is because Medicaid has on file that the recipient has other insurance. Recipients are required to keep Medicaid informed of any health insurance information. Providers are also responsible for notifying Medicaid of third party insurance they find out about as well as informing Medicaid of any third party payments they receive on behalf of the recipient.

State Medicaid agencies are required to reject claims wherever third party liability exists if they receive a claim without documentation of the primary insurance payment.

In instances that third party exists, if the Medicaid allowed amount is greater than the third party payment, Medicaid will pay the difference up to Medicaid's allowed amount. However, in instances that the third party payment is more than what Medicaid allows, Medicaid makes a "zero payment". This means that the provider must accept the primary insurance payment as payment in full and cannot balance bill the patient.

It is important to keep in mind that Medicaid is not an insurer. Medicaid is a program that makes medical payments on behalf of the recipient. If the provider or recipient fail to comply with any health insurance requirements that results in a denied payment, Medicaid can deny also due to noncompliance.

Third party liability is not just limited to Medicare and health insurance. It also refers to liability insurance due to motor vehicle accidents and work-related injuries or illness. For specific information on billing Medicaid claims, refer to your state Medicaid agency.


  1. Highly energetic blog, I liked that a lot.
    Will there be a part 2?

    Also visit my homepage Private cloud

  2. Hi, thе whοle thing iѕ going sounԁ herе anԁ ofcoursе evеrу
    one іs sharing ԁata, that's actually fine, keep up writing.

    Look into my blog post Applicazioni facebook

  3. hp laserjet p1505 printer vehicle drivers download.

    my web page xerox phaser 8560mfp driver

  4. Exists a means to alphabatize the labels once you get them keyed in?

    Here is my blog - Xerox phaser 8560

  5. Pls for your kindness send me the video clip idea of making pcb
    with hp printer.

    Also visit my website xerox phaser 8560 drivers

  6. Thankyou in this grand post, My business is glad I stumbled upon
    this webpage on yahoo.

    Feel free to surf to my website

  7. Many thanks for the option. This operated terrific !

    My web blog; xerox phaser 8560 driver

  8. Thanks a lot. Attempted rather some time and various attractions, yours was

    Here is my web page;

  9. hi,
    we are attempting to print some buisiness cards with thermosensitive ink that
    would respond with the warmth.

    Check out my homepage :: xerox phaser 8560 toner

  10. No way to alphabetize after you arrangement the preliminary tags, yet it is extremely fast to make use of
    Ctrl+F (find feature) to rapidly find a name to edit or eliminate from your list.
    Best of luck!

    my blog post ... xerox phaser 8560 manual

  11. Yes, you could download Hp Laserjet 1020 printer drivers from this website, plz observe this like for Hp laserjet vehicle driver Download
    for hp 1020.

    Also visit my site :: xerox phaser 8560 error codes

  12. Hey I am so thrilled I found your blog page, I really found you by error, while I was
    researching on Digg for something else, Anyhow I am here now and would just like to say cheers for a incredible post and a all
    round thrilling blog (I also love the theme/design), I don't have time to read it all at the minute but I have bookmarked it and also added in your RSS feeds, so when I have time I will be back to read a lot more, Please do keep up the superb work.

    my website - xerox 8560 service manual

  13. Hey...Thanku so much.This information is very useful to me...
    Credential verification services

  14. Love love love the flower and a circle one, although every one is completely beautiful.
    I'd send it to my mom in Sweden...she has been there for two-1/24 months and returns next summer to finally meet my daughter/her granddaughter!

    my homepage handmade silver jewellery

  15. Many thanks match, functioned like a beauty. This has actually
    been doing my head in for days !!

    Feel free to surf to my website ... Xerox Phaser 8560Mfp D (Blogspot.Fr)


Search For More Information

Custom Search
Shop Online from Amazon Products

Page Count