Medicaid

Spectrum Medical Inc. will file your primary or secondary claim to Medicaid.

Claims are submitted either assigned and payment is made directly to Spectrum Medical Inc. Patients are responsible to pay Spectrum Medical Inc. the copay as deemed by Medicaid.

Medicaid may have utilization limits and medical necessity criteria for certain items and services. Utilization limits restrict how often and/or how many Medicaid will pay for certain items and services. These limits are not always disclosed to Spectrum Medical Inc.  Medical necessity criteria determine which items and services may or may not be covered by Medicaid.

Medicaid does not pay for E-Z reachers, sock aids, band-aids, Q-tips, walker baskets or most items that may be purchased “over-the-counter”. Only one ambulatory aid will be covered by Medicaid. If a patient requires a walker and a wheelchair, one can be billed to Medicaid and the second item will be patient pay.

Before these items or services are provided, Medicaid patients will be asked to read and sign a “Denial of Services” form that explains Medicaid payment restrictions. By signing the Denial of Services form, you assume financial responsibility in the event Medicaid denies payment.