Question

topic is Medicaid basic health program

explain why you chose this topic and how you think it would be useful to you as a medical office manager or professional health insurance specialist. include brief overview of the topic

Answer 1

Medicaid Basic health care program

Introduction - Medicaid health programs are different from Medicare program as the former include low income individual and families and cover all the hospital services , medical services , physician services , laboratory and X ray expenses and home heath care services . It is no cost ( potential copayment ) heath program which is available at any time .

For claiming a Medicaid coverage for children ,the house hold monthly gross income must be between $ 2504- $6370 ( for 8 member family) and for adult coverage the income ranges between $1800 to $ 4507.

For older people more than 65 yr the income must below $2300 / month .this program is funded jointly by states and federal government of America . The federal government pays the state a specific percentage of expenditure which is called as ' Federal medical assistant percentage ' ( FMAP) . Now it's the responsibility of states that they fund their share of Medicaid expenditure for all the care and medical services available under their state plan .

Now state have right to establish their own Medicaid provider payment rate under federal requirements and pay for service through other methods like fee for service or manage care services .

The reason a health care provider must know the rules and regulations of Medicaid Basic health problems because it unable the provider to know people who come under program and this helps in providing better treatment to patients .

As a medical care manager one must know all rules and regulations for claiming the insurance money so that he help patients or family and also prevent any fraud case from claiming the money .