Maryland Medicaid: Balance billing is not permitted
AI Summary
Maryland Medicaid providers are reminded that balance billing members is strictly prohibited in all circumstances, including when charges exceed fee schedules, claims are denied, or claims are under review. Providers must verify eligibility before services and can only collect Maryland Medicaid-permitted cost-sharing.
Action Required
Immediately: All staff must stop balance billing Maryland Medicaid members under any circumstances. Billing team must verify member eligibility before all services through the UnitedHealthcare Provider Portal. Front desk staff must inform members in advance which services are covered/non-covered and collect only permitted cost-sharing. Bill all other insurance carriers first before Maryland Medicaid. Violation may result in payment recoupment, sanctions, or termination from the program.
Plan Types
Medicaid
States
MD
Specialties
all-specialties