Any payments from a state Medicaid program to a healthcare provider are considered as 'Payment in Full'.

Any payments from a state Medicaid program to a healthcare provider are considered as 'Payment in Full'.

• A. True
• B. False
• C. Not applicable
• D. Not stated

Answer: (A)

Medicaid payments for a covered service are treated as the final settlement for that claim. Medicaid uses predetermined reimbursement rates, and when the service is covered, the payment from the state program is considered payment in full for that service. Providers accepting Medicaid agree not to seek additional payment from the patient for that covered service beyond any allowed cost-sharing required by the program. In short, for services Medicaid covers, the payment it provides satisfies the provider’s charge for that claim, which is why this statement is true.

Medicaid payments for a covered service are treated as the final settlement for that claim. Medicaid uses predetermined reimbursement rates, and when the service is covered, the payment from the state program is considered payment in full for that service. Providers accepting Medicaid agree not to seek additional payment from the patient for that covered service beyond any allowed cost-sharing required by the program. In short, for services Medicaid covers, the payment it provides satisfies the provider’s charge for that claim, which is why this statement is true.