We are preparing to update to 5.5 in about six months and are attempting to write outpatient rules for Illinois Medicaid. Are there any sites in Illinois who are using 5.5, or have rules written for outpatient services that also perform the up-front adjustment? We have not used proration for these types of accounts in the past due to the many exceptions Medicaid has with their payment methods.
Some of the issues we are running into are for example when a Medicaid patient is seen in the emergency room and theN subsequently has surgery, Medicaid bases the payment on the greater of the two services. We are not sure how to write this into a rule. If you are using 5.5 proration for any outpatient Medicaid services, can you please contact me either by e-mail, or the phone number below? If you have also struggled with writing these types of rules, is there any interest in getting a group together to propose that Meditech write these for Illinois sites at a cost? Thank you, Wendy Miller Applications Specialist Information Systems Sarah Bush Lincoln Health Center (217) 258-4189 [EMAIL PROTECTED]
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