[
quote=Jerry Garcia]We had a health care provider one time that used some place in Minnisota for our normal and reasonable charge. [/quote]

I doubt that can be done. The processing centers simply apply the code times the rate for that region. (Every possible procedure has a code, so if the code for a broken arm is 2234 the centers computers calculate payment based on the code and the 75 percentile for that charge in the region where the Dr practices.) Unless he lied about where he lived there is no way what you describe could be of any benefit to the Dr. it wouldn't matter what the Dr. billed.

What the doctors could do to raise payment rates was bill at a very high rate. That would NOT affect the current fee paid but would tend to raise the 75% for future payment cycles.

You might be interested to know that Medicaid is a state /federal partnership. The feds match the states cost at varying rate depending on the per capita income of the state. So more wealthy states get less form the feds and poorer states get more.

Again this is all 10 years old. May be different now. Thank God I don’t need to know this stuff anymore.

I do find it amusing that so many folks are sure the system is all farked up but really have no idea how it works.