Frequently Asked Questions

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Frequently Asked Questions


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For ambulatory care, are children under 19 exempt from copay?

Children under 19 are exempt from all copays.

Can you only see a certain amount of beneficiaries?

Yes, but you must have a visible sign stating so.

Can you export data from Web Tool?

Not at this time, however you can print screen and save it as a file.

Will recertification dates be listed on Web Tool?

No, it would violate HIPPA.

If the beneficiary doesn’t have an ID number for the MCO, how do we obtain it?

Contact the MCO.

What should I do if one line does not pay on your claim?

Correct and refile that one line.

Can I handwrite on the claim forms?

Yes you can, or you use a printing service.

How does Medicaid know what the provider is receiving from another carrier/third party payer?

There are spaces/sections on the claim form that identify what you receive from the other carrier.

Do we need to send an EOB?

An Explanation of Benefits from a third party payer should be kept on file in the provider’s office, especially if the payer didn’t submit payment.

How are MCO plans chosen for a beneficiary if they are auto-enrolled?

The plan is chosen based on the beneficiary’s needs, service area, and any needed specialists.

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