In an outpatient setting, which insurance is considered last when processing claims?

In an outpatient setting, which insurance is considered last when processing claims?

• A. Medicare Part A
• B. AARP supplemental
• C. Medicaid
• D. Commercial insurance

Answer: (C)

In the context of processing claims in an outpatient setting, Medicaid is considered the payer of last resort. This means that it typically comes into play after other insurances have been billed. The order of billing usually starts with any primary commercial insurance or employer-provided plans, followed by supplemental insurances, and finally Medicaid. Medicaid is designed to cover patients who may not have other forms of insurance, thereby acting as a safety net for low-income individuals. In practice, if a patient has multiple sources of insurance coverage, the claims process will first seek reimbursement from those primary and secondary insurances, and only after those claims have been settled will Medicaid be billed. This helps ensure that Medicaid funds are preserved for those who may have no other coverage options.

In the context of processing claims in an outpatient setting, Medicaid is considered the payer of last resort. This means that it typically comes into play after other insurances have been billed. The order of billing usually starts with any primary commercial insurance or employer-provided plans, followed by supplemental insurances, and finally Medicaid.

Medicaid is designed to cover patients who may not have other forms of insurance, thereby acting as a safety net for low-income individuals. In practice, if a patient has multiple sources of insurance coverage, the claims process will first seek reimbursement from those primary and secondary insurances, and only after those claims have been settled will Medicaid be billed. This helps ensure that Medicaid funds are preserved for those who may have no other coverage options.