Quote:
Originally Posted by Tobra
Generally the reason given for this was that the 80% that I got from Medicare was more than they allowed, so we are not paying our end. I believe this has something to do with them lowering their fee schedule so it is the lowest reimbursement for any Medicaid program in the country.
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So regardless of what you do, they will hang their hat on the "more than they allowed" figure(s).
Your entity got paid by the primary insurer more than the secondary insurance determined is fair in total for the folks that require the subsidies.
Argh!
I think you know the outcome regardless of what you do. (i.e., Assume the position)