It is important to remember, except for a very few exceptions, a Medicaid member cannot be billed for health care services. Please review the MDwise provider manual for these exceptions and the criteria you must meet before billing a member.
If a provider has received payment on a Medicaid claim, the member may never be asked to pay an additional amount, or be balance-billed, for that claim. When cost-sharing is no longer suspended, providers may bill a Healthy Indiana Plan (HIP) member for a co-pay if the member was unable to pay at the time of service. These co-pays are anywhere from $4 for an office visit to $75 for a hospital stay.