Medicaid Providers

Medicaid providers are those doctor's offices, clinics, and hospitals that have agreed to accept this form of payment for services. Individuals that are approved for Medicaid are often given a list of providers so they can choose who they want to be seen by. It is important to do this early instead of waiting until you need to be seen. Most hospitals accept Medicaid so it isn’t a problem. Yet doctor’s offices and clinics have a set number of slots they will allow to accept this form of payment for.

In many states, you only have 60 days to choose who your provider will be. You will then need to call an 800 number to have that information added to your Medicaid card. Should you not complete this process though a provider will be assigned to you. This can be complicated to straighten out. In the mean time you will either have to see a doctor you don’t want to or pay out of pocket to continue your services with your current provider.

Most Medicaid programs require you to either choose a Primary Care Physician known as a PCP or a Health Management Organization known as an HMO. In many instances though it will depend on what particular types of services are available in your area. Should your primary physician recommend that you see a specialist, you will need to get that approved by Medicaid. If you don’t, there is a very good chance that you will be stuck paying those bills on your own.

Not all specialists are willing to accept Medicaid even if you are approved to see one. Make sure before you make an appointment with someone that they are going to honor the type of coverage you have. Don’t wait until you show up for your appointment to discuss this issue. It can result in the treatment you need being delayed.

You do have the right to change your Medicaid provider should you choose to do so. Make sure you follow the procedure for doing so in your state. Some only require a phone call while others require something in writing before they can process such a change. Make sure you have contacted the new provide to ensure they will take you as a patient. If you have the name changed on your Medicaid card but they won’t take you this isn’t going to benefit you in any way.