Medicaid Managed Care

When the "Medicaid Managed Care" policy type is configured for a payer, a tile on the COB will display right after the Medicaid tile. You cannot add a Medicaid and Medicaid Managed Care plan in the COB at the same time. Medicaid Managed Care can be posted as primary, secondary, and/or tertiary.

Note: If you click the ‘Medicaid Managed Care’ button in the COB and nothing shows as an option, you will need to go to Admin > Billing > Payers and administer your plans as described below.

How to administer Medicaid Managed Care

Payers will not automatically show up as Medicaid Managed Care, you will need to add this type to the payers/benefit plan before this will happen. In addition, benefit plans cannot be changed to Medicaid Managed Care, instead you must disable the existing plan and add a new one.

To administer this new policy type:

  1. Click Payers on the navigation bar.

  2. Find the Medicaid payer on the list and then click the payer name.

  3. Click the Policies tab click Add a policy.

  4. Click on the Policy typefield and select Medicaid Managed Care.

  5. Click the Electronic filing indicator field and select the appropriate indicator. In most cases the indicator will be "MC-Medicaid."

  6. After completing the rest of the necessary fields, click Save & close. The new policy will display in the list under the Policies heading.