Asked by Farhan Hossain on May 06, 2024
Verified
Mrs. Lawrence is an elderly diabetic patient who is on Medicare. She recently injured her lower left leg, and since then has had trouble with open sores or ulcers on that leg. She came to the office last week to have the physician examine and treat the ulcers. At that time, you checked, and she qualified for Medicaid as well as Medicare. She has come to the office today for follow-up care and treatment. Which of the following should you do first?
A) Ensure that the physician signs the Medicaid claim
B) Contact Medicare for preauthorization
C) Contact Medicaid to verify her eligibility
D) Send the claim to Medicaid
E) Notify Mrs. Lawrence that she will not have to pay anything
Medicaid Claim
A request for payment that healthcare providers submit to Medicaid for covered services provided to enrolled members.
Medicare Preauthorization
The requirement of obtaining approval from Medicare before it will cover certain prescribed medications or procedures.
Diabetic Patient
A diabetic patient is a person diagnosed with diabetes, a chronic condition characterized by high levels of glucose in the blood.
- Gain insight into the requirements needed to qualify for Medicaid.
Verified Answer
EM
Emily MontealvoMay 11, 2024
Final Answer :
C
Explanation :
Before providing follow-up care and treatment, it's essential to verify Mrs. Lawrence's Medicaid eligibility to ensure that the services will be covered. This step is crucial because eligibility can change, and confirming it helps in planning the billing process accordingly.
Learning Objectives
- Gain insight into the requirements needed to qualify for Medicaid.