Monthly Medicaid Spend Down

Path: Patient > General > Payers

Using the Monthly Medicaid Spend Down functionality, Spend Down is applied over the pay control effective period on a monthly basis.

To assign the Monthly Medicaid Spend Down program to the patient, refer to the Pay Control – Payers tab for the detailed field description. On this tab, fill in the Spend Down, From, and To fields.

In case of providing short-term services to a patient, the Spend Down amount can be prorated over a desired period.

• The Monthly Medicaid Spend Down amount can be prorated only for Benefit and Hybrid pay sources.
• To deactivate the amount proration, select the Do not pro-rate Spend Down for partial month check box on the Print Variations tab of Administration>Financial>Insurance Codes.
• The application prorates the amount over patient's period of getting care, so the Spend Down amount is divided over the day amount over patient's period of getting care, so the Spend Down amount is divided over the day.

Note: If Do not pro-rate Spend Down for partial month is selected, Billing Rules for Day of Termination are not applicable.

You can also set the needed day of termination billing rule options for the Spend Down amount and configure additional Spend Down settings for the selected insurance code on the Liability/Spend Down tab of the Insurance Codes window (in Administration>Financial>Insurance Codes).