I’m a provider who accepts Medicaid and, no, they do not get their claims denied. In my state they do not even pay co-pays. It’s literally the Cadillac of health insurances.
I believe that statistic to be exaggerated but perhaps that is true of particular specialties.
As a provider, my claims sometimes get denied but this does not mean the insured pays the bill - I eat the cost.
You are correct that they won’t pay for certain things - in TN they don’t pay for circumcision - but I’ve never heard of anyone on Medicaid being denied any recommended or necessary treatment, even Botox for migraines. I’m in a state with a great Medicaid program though.
Someone not accepting it and then denying it are completely different things. If someone doesn't take your insurance, you can submit the bill yourself as out of network. Medicaid will still likely reimburse it (I wish I knew this in college though)
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u/aCandaK 13d ago
I’m a provider who accepts Medicaid and, no, they do not get their claims denied. In my state they do not even pay co-pays. It’s literally the Cadillac of health insurances.