[btrevolution4]

We've been billing Medicare and when the claims crossover to Medi-cal for the 20% payment, Medi-cal is denying the payment as a RAD CODE: 0444 and 0442. Is there any way to collect this amount or is it a zero pay write-off? Can we legally do anything against the State or what is the rules for these cutbacks that are not allowed by Medi-cal? We're losing a lot of money. Thanks in advance and have a nice weekend everyone!

[serina.breen@comcast.net]

I am not certain but it is my understanding that for code 0442, you cannot
collect on because that code means that the "Medicare payment meets or
exceeds Medi-Cal maximum reimbursement."

Medi-cal will not pay an amount in excess of their own maximum reimbursement
amount regardless of what medicare's allowable is.

For 0444, you may be able to still collect on it as a "charpentier." You
will need to go to medi-cal website for more info:

http://www.medi-cal.ca.gov

type " cutback denial codes" in the search field.

Serina