By clicking
Talk to a Specialist, you agree to our
Privacy Policy. You also consent to receive calls and texts, which may be autodialed, from us and our customer communities. Your consent is not a condition to using our service. Please visit our
Terms of Use. for information about our privacy practices.
I would check with the Medicaid assigned case worker.
Medicaid should have sent whomever is on file as the contact person for the NH resident a letter of eligibility that states what the copay is. You kinda need to make sure this is accurate. For my mom, it was SS $ 800 and retirement 1K and personal needs allowance of $ 60. So every month, I paid from mom's bank account $ 1,740 to the NH as her Medicaid required SOC.
So is the facility getting the co-pay & have they gotten it for every month she has been in the facility? if not, it needs to be paid. If those funds were spent on other things by family, then family needs to make up the difference.
If you are good on the SOC, then it's a billing mistake….I'd send a note with the Medicaid eligibility letter to them and that should take care of it.
A couple of years ago, I came up with a policy that has kept me sane. Whenever a medical bill comes, if it's for more than my co-pay, I assume it's a mistake. Coming at these situations from that point of view makes for calmer conversations.
So, start out by clarifying in your mind who the bill is addressed to. Was your mother approved for Medicaid? Was she admitted as Medicaid pending? If so, I believe that the payment from Medicaid will be retroactive to her admission date.
Talk to the business office and please let us know how you make out.