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Frequently Asked Questions

 
Q:
Long Term Care - How should Medicaid be billed for clients with Medicare?
A:

For some Long-Term Care (LTC) clients, Medicaid will cover the days designated by Medicare as Medicare coinsurance days. Report the Medicare Coinsurance Days in loop 2300, QTY segment (QTY01 = CD and QTY02 = the number of days). In this case, loop 2320 does not need to be reported because NYS Medicaid will receive all required information from the Department of Health. In this situation any days that Medicare did not cover can be billed to Medicaid on the same claim. The days Medicare did not cover would become Medicaid Covered Days in loop 2300, QTY segment (QTY01 = CA and QTY02 = number of Medicaid Full days) on the same claim.


 

Notes and Comments

Created:

May 21, 2007            

Last Modified:

July 27, 2007     
 
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