What are the most common reasons for Medicaid Denial?

Medicaid is a mandated program run by the central government to provide healthcare facilities to low-income groups or residents across the United States, managed at the state level. The procedure and requirements of the application may vary with different states. But as a government program, there are certain specific criteria to qualify for the coverage.

Medicaid covers healthcare costs like doctor visits, hospital stays, the care offered in a nursing home, and many more. These facilities are crucial for any patient, and getting its cost covered is a sigh of relief for the patients. But a medical application denial can leave the patient in a dire financial situation. The reason for application denials can be anything. Some are common, and you can resolve them faster than others. 

What are the reasons for the denial of the application?

The reason for Medicaid rejection can be many. The applicants can fix the denial reasons for the denial to receive the claim. For example, an incomplete application is one of the most common reasons for rejection. An application for Medicaid requires documents like investment account statements, bank statements, tax returns, retirement income information, life insurance policy information, and asset and other property information.

These documents determine your financial eligibility for the claim. The authorities will reject the claim if an applicant forgets to submit any of these documents. Though the applicant will have the option to start over the application again, there will be a delay in the claim.

A caseworker might misinterpret some rules or lose a document. Sometimes, they may also give incorrect advice to the applicants due to the stress of overwork. All these errors can lead to the denial of the application. Other times, the application gets rejected or denied because of the caseworker’s mistake.

Failing to meet the financial requirements of Medicaid is among the most common reason for the application denial. A person or patient sometimes believes that they qualify for the claim and fill out the application, but they mistakenly miscalculate their assets.

Another reason for the denial is the transfer of assets. The authorities will thoroughly examine the transfer if the applicant disposed of or transferred an asset within five years of applying for a claim. If you sell an undervalued asset, the chances of rejection are likely, since many people sell their assets just to be eligible for the claim.

What to do if Medicaid gets denied?

If you want to get your Medicaid approved and receive the claim, we advise you to hire a professional attorney from Autrey Law Firm. They are an expert in planning and filing your Medicaid application. Filling out a Medicaid application can be strenuous and hectic. A common and inexperienced person tends to make some mistakes, leading to the rejection of your application and delaying your claim.

End words Now you must be aware of how small mistakes can lead to a claim denial and distress you. So, it is better to seek the help of a professional attorney, as they will navigate you through all the filing processes and assure you of the claim.