How to File Medicaid Claims

Medicaid is a combination state and federal health insurance program for low income individuals that is administered by the individual states. Each state sets its own standards for Medicaid eligibility and services provided, within federal guidelines. Each state also provides its own application forms and claim forms. Claim forms are usually submitted by the health care provider. Claim forms only need to be filled out by individuals when specific health services are not covered or when a health care provider does not submit claims to Medicaid.

Getting the Correct Claim Forms

Contact your local Medicaid office to get the appropriate claim forms. Many states now have useful websites where you can find and download most necessary forms, but depending on the circumstances you might have to make a trip down to the Medicaid office to fill out the forms.

Enter the correct service codes on the forms. Service codes specify the exact type of treatment you are referring to and are essential for correct processing of the forms.

Either mail or return the forms to the requested address in person. If you are mailing the forms it is wise to use certified or registered mail. In some cases it might be possible to fax or email a file containing a signed copy of the form.