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Wisconsin Department of Health and Family Services Obsolete Medicaid Eligibility Handbook For the current MEH, see http://www.emhandbooks.wi.gov/meh-ebd/ For the current BC Plus Handbook, see http://www.emhandbooks.wi.gov/bcplus/ |
When the client receives a medical bill that is equal to or greater than the amount s/he still owes on the deductible, s/he can be certified for MA. S/he must pay the part of the bill that equals the deductible. MA will consider the remainder of the bill for payment.
To make sure that MA does not pay what the client still owes on the deductible, send a Medicaid Remaining Deductible Update ( HCF 10109 ) to EDS indicating the amount of the bill that the client owes. EDS subtracts this amount from the bill and MA pays the rest.
Fill out the Medicaid Remaining Deductible Update ( HCF 10109 ) only if:
A MA certified provider has provided the billed services.
The person, having met the deductible, is being certified. If s/he is not being certified, MA will not pay any of the bill.
The date of the bill is the date the deductible was met. Since the client is not eligible until s/he has met the deductible, s/he still owes for all bills prior to that date.
Do not send more than one bill. In the series of bills which the client may submit to you, there will be only one bill which is larger than the amount needed to meet the deductible. MA will consider the remainder of the bill for payment.
This page last updated in Release Number: 03-02
Release Date:04-01-03
Effective Date: 04/01/03