Are there situations when the nonparticipating provider can bill Medical Assistance clients for their care?
MAA assumes that nonparticipating providers do not treat Medical Assistance clients. If a provider wishes to treat Medical Assistance clients, the provider needs to enroll with MAA.However, if a Medical Assistance client seeks care from a nonparticipating provider, is informed and understands that the provider does not accept Medical Assistance, and the client still chooses to receive services from that provider with the understanding that the services are available at no cost to the client from a Medical Assistance provider, then the client will be financially responsible for the services. See also WAC 388-502-0160 regarding when participating providers may bill Medical Assistance clients.
Related Questions
- Can a nonparticipating provider bill a Medical Assistance client who is also eligible for Medicare for amounts above what Medicare pays that typically would be paid by Medical Assistance?
- Are there situations when the nonparticipating provider can bill Medical Assistance clients for their care?
- In what medical situations should a health care provider obtain the services of an interpreter?
