Durable Medical Equipment Billing in Kentucky

Medicaid in Kentucky runs as Kentucky Medicaid and is delivered largely through commercial managed care plans, so most Medicaid claims are adjudicated by an insurer with its own filing window and its own authorization rules rather than by the state.

Kentucky is a no-fault state. For an auto injury the auto carrier is the payer of first resort, not the health plan, and billing the health plan first produces a denial that looks like a coverage problem but is a sequencing problem.

• Documentation assembled after delivery
• Missing face-to-face encounter record
• Item not covered under the state plan