Reply To: WIC diagnosis code

[Missouri Public Health Association]

When we have a client that has Medicaid and Commercial as primary, we need to get a denial from the primary so Medicaid will pay. The comment that UMR gives is not a denial but a request for the correct diagnosis code. I’m sure they won’t pay anyway but we have to have a proper denial so Medicaid will pay. Occasionally, the commercial insurance will pay a portion and Medicaid will pay the rest.