Remember: Check insurance status before each procedure!

Recently we have had a few agencies report to us that clients seen through WWC Clinical Services last fiscal year (June 30, 2014 to June 29, 2015) were actually billed to and paid by Medicaid. While agencies are not required to switch funding from WWC Clinical Services to Medicaid for services rendered between the client’s enrollment notification date and back-dated enrollment date, it is not allowable to charge the same service to two funders (i.e., WWC Clinical Services and Medicaid). When another funder has been charged for services rendered in a previous fiscal year, agencies must refund CDPHE funds paid for these services by sending CDPHE a check. If your agency identifies a change in funding source for services performed during the active fiscal year, simply update the funding source for affected procedures and the funds will be automatically reversed on your next grant activity statement.

While we know this may be inevitable for services performed last fiscal year, below are some best practices to help you avoid this in the future. We will remind agencies during our major mid-year and end-of-year data entry pushes. 

• Follow the new policy that insurance status be assessed before each clinical service is provided with WWC funds. 
• Verify regularly that WWC Clinical Services clients have not retroactively been billed to Medicaid. 

Please contact Emily, Marina or your WWC program coordinator with any questions.