Medicaid - Non-Covered Procedures

As a provider of services for the Medicaid population, there are a few requirements that you should be aware of regarding non-covered procedures. Please read the excerpt below from the Doral provider manual:

"2.02 Payment for Non-Covered Services Participating Providers shall hold Members, Doral, Plan and Agency harmless for the payment of non-Covered Services except as provided in this paragraph. Provider may bill a Member for Non-Covered Services if the Provider obtains a written waiver from the Member prior to rendering such service that indicates:

• the services to be provided;
• Doral, Plan and Agency will not pay for or be liable for said services; and
• Member will be financially liable for such services."

Please remember to obtain the patient's written waiver and signature before collecting or billing for non-covered procedures. If you need additional information on this requirement or assistance with writing your waiver documents, contact your D-TECH account representative.