When the Healthy Michigan Plan kicked off in April 2014, the Michigan Department of Human Services experienced some unexpected system issues that prevented them from activating retroactive coverage when processing applications for the Healthy Michigan Plan and other Medicaid programs. Because of this, many applicants with outstanding medical bills from back to January 2014, were being held personally responsible for their claims by providers.
The state recently released a statement that the system issues have now been resolved and they are beginning to reprocess eligibility for those eligibility groups affected by this problem (available here). The provider and beneficiary will soon be sent notice by the state of this process and how to go about being reimbursed. Specific billing instructions will be furnished to providers and the Medicaid and Healthy Michigan Plan beneficiaries are being advised to contact providers to request a refund if they had made payment on the claims themselves.
This is great news for the providers and their patients who have been trying to secure coverage for quite some time to cover their outstanding claims. There are many cases needing to be resolved, this initiative should now quicken that process. If you have already written accounts off to charity or your financial assistance programs, you will now be able to reverse them out and be paid by Medicaid instead.
A copy of the L-letter 15-48 may be found HERE which includes a sample of the provider and beneficiary letters being sent out by the state as coverage is activated.
Please let us know if you have any questions or need any assistance in this matter.
Chief Administrative Office at Advomas