| Medicaid providers are those doctor's offices, | | | | to take some time to make some phone calls to |
| clinics, and hospitals that have agreed to accept | | | | find out who is accepting new patients with |
| this form of payment for services. Individuals that | | | | Medicaid coverage. If you aren't having any luck |
| are approved for Medicaid are often given a list | | | | make sure you report that information to your |
| of providers so they can choose who they want | | | | local legislator. That way they can be aware of |
| to be seen by. It is important to do this early | | | | the problem and work to resolve it. |
| instead of waiting until you need to be seen. Most | | | | Many local agencies including human services |
| hospitals accept Medicaid so it isn't a problem. Yet | | | | continue to contact doctors in the area. They try |
| doctor's offices and clinics have a set number of | | | | to encourage them to look at accepting patients |
| slots they will allow to accept this form of | | | | with Medicaid. They also work hard to ensure that |
| payment for. | | | | every single doctor that does accept Medicaid is |
| In many states, you only have 60 days to | | | | offering quality services to their patients. Just |
| choose who your provider will be. You will then | | | | because a person isn't able to pay for the medical |
| need to call an 800 number to have that | | | | care out of their own pocket, they shouldn't be |
| information added to your Medicaid card. Should | | | | denied the very best of care. |
| you not complete this process though a provider | | | | Should you have any problems with a doctor that |
| will be assigned to you. This can be complicated to | | | | is accepting Medicaid you need to report it. Too |
| straighten out. In the mean time you will either | | | | many people are afraid to do so as they worry |
| have to see a doctor you don't want to or pay | | | | about being able to find another provider. If you |
| out of pocket to continue your services with your | | | | find your bills for Medicaid aren't correct you also |
| current provider. | | | | need to report this. There have been many cases |
| Most Medicaid programs require you to either | | | | of Medicaid fraud that have been uncovered this |
| choose a Primary Care Physician known as a PCP | | | | way. |
| or a Health Management Organization known as | | | | Medicaid is a very good program that is to help |
| an HMO. In many instances though it will depend | | | | those that need medical and dental coverage. In |
| on what particular types of services are available | | | | most instances, without the Medicaid they simply |
| in your area. Should your primary physician | | | | wouldn't be able to afford it. Therefore they |
| recommend that you see a specialist, you will | | | | wouldn't get the care they needed, especially |
| need to get that approved by Medicaid. If you | | | | when it comes to preventative care. One issue |
| don't, there is a very good chance that you will | | | | with Medicaid though is that it isn't always used as |
| be stuck paying those bills on your own. | | | | it should be. There are problems with fraud both |
| Not all specialists are willing to accept Medicaid | | | | from people approved for the program and by |
| even if you are approved to see one. Make sure | | | | providers. |
| before you make an appointment with someone | | | | Medicaid fraud happens in many ways from the |
| that they are going to honor the type of | | | | individual side of things. A person many not report |
| coverage you have. Don't wait until you show up | | | | all of the information on their application correctly |
| for your appointment to discuss this issue. It can | | | | in order to be eligible. They may end up omitting |
| result in the treatment you need being delayed. | | | | income or various household members that have |
| You do have the right to change your Medicaid | | | | a sufficient income to contribute to the household. |
| provider should you choose to do so. Make sure | | | | It also occurs when someone allows another |
| you follow the procedure for doing so in your | | | | person to use their Medicaid card for services. |
| state. Some only require a phone call while others | | | | There are auditors in place to review charges by |
| require something in writing before they can | | | | medical providers. They look for patterns of |
| process such a change. Make sure you have | | | | behavior when it comes to billing of Medicaid |
| contacted the new provide to ensure they will | | | | patients. They want to make sure they aren't |
| take you as a patient. If you have the name | | | | billing for things that haven't occurred. They also |
| changed on your Medicaid card but they won't | | | | want to make sure Medicaid patients aren't being |
| take you this isn't going to benefit you in any | | | | subjected to tests that they don't need in order |
| way. | | | | for them to make money. |
| Medicaid is a type of insurance for those that | | | | There are also fraud hotlines where people can |
| have a very low income. The program is federally | | | | call in to report other people who may be getting |
| funded and then independently operated by each | | | | Medicaid benefits fraudulently. A person can make |
| state. One of the biggest problems with Medicaid | | | | such reports anonymously so that they don't |
| though is finding a doctor that will accept it. Many | | | | have to tell anyone who they are. Generally it is |
| individuals are quite frustrated to find out they are | | | | friends or family members that don't feel it is |
| eligible for Medicaid yet they can't find a provider | | | | right that someone is illegally getting such benefits |
| that accepts it in their area. | | | | that turn them in. Most departments of human |
| Some individuals are traveling 60 or more miles in | | | | service agencies have a fraud unit that can |
| order to find a Medicaid doctor. If this is the case | | | | investigate such matters. |
| the individual is often eligible for reimbursement | | | | It is believed the Federal government is bilked out |
| for the cost of gas to get to these appointments. | | | | of millions of dollars annually due to the various |
| There is a set amount that is paid per mile for | | | | forms of Medicaid fraud. As a result they have |
| the trip to the doctor's office. You must have this | | | | implemented harsh penalties for those caught to |
| type of reimbursement pre-approved though | | | | be involved in such forms of fraud. Individuals |
| before you travel. Should there be a Medicaid | | | | have had to repay the funds, pay a fine, and |
| doctor in your area available but you choose to | | | | even serve jail time as part of the requirements |
| ravel to see someone else you will be responsible | | | | under our justice system. The repercussions for |
| for the cost of the travel on your own. | | | | any form of Medicaid fraud aren't going to be |
| If you are struggling to find a Medicaid doctor in | | | | lenient. You can be sure the Federal government |
| your area, contact your local department of | | | | is working hard to make examples out of those |
| human services. They should be able to provide | | | | they do catch. |
| you with a current list of providers. You will need | | | | |