Voucher Process
Any patient who does not need or request financial assistance with medical bills should be treated and billed like any other patient.
If the patient requires financial assistance from Migrant Health Service, Inc. (MHSI), a signed voucher must be presented or verbal authorization by a MHSI nurse may be necessary in some instances, such as pre- or post-season and for our Mobile Unit patients.
Remember, MHSI's reimubrsement levels may not cover the complete cost of the visit. Any balance remaining after payment by MHSI is the responsiblity of the patient or parent/guardian. The only exception to this is when there is signed Physican Agreement in place, then the patient is only responsible for the balance of any charges for lab, x-ray and reading. The balance of the office visit (CPT 99211 - 99215) after MHSI payment would be written off.
Each patient must be currently registered with MHSI and have a voucher which is only valid for the date indicated. Subsequent visits will require additional vouchers.
The procedure to follow if the patient does not have a voucher is:
• Ask the patient who will be responsible for the bill. If they say "Migrant Health Service, Inc.", please ask the patient for the following information:
- Patient's Name
- Date of Birth
- Head of Household
- Local Address
- Telephone
- Home Base Address
• Call the MHSI Health Center for authorization.
MHSI Vouchers
Patients who have been seen by our Health Center staff will bring a copy (white) of the voucher to the provider, or it will be mailed or faxed to you. Please follow these steps for completion.
The voucher (single white sheet) requires attaching an itemized bill/statment which must include the procedure code(s) (CPT or CDT) and diagnosis code(s) (ICD-9). A HCFA 1500 or UB92 form is preferred. Pharmacies should attach an RX label.
The medical/lab report must be attached or the voucher cannot be honored for payment.
If you fax the voucher back to us, please fax it to 218-236-6507 ATTN: Betty.
Before the Health Center closes, the nurse will make arrangements with you (clinics only) for any patients that have future appointments. For anyone else, please call the Central Office at 218-236-6502 or Toll Free at 1-800-842-8693 before providing service. Please refer to our guidelines in our Provider letter.
If vouchers are to be VOID - please return the voucher to Central Office with an explanation on why it is to be voided.
If it appears that our funds are rapidly depleting, we will give you advance notice.
Migrant Head Start Vouchers (Yellow)
All Migrant Head Start School vouchers should be mailed back to MHSI - not to the schools.
Migrant Head Start school vouchers are reimbursed at a different rate than MHSI vouchers. Please contact Betty at the Central office with any questions.
The top yellow copy requires attaching an itemized bill/statement which must include the procedure code(s) (CPT or CDT) and diagnosis code(s) (ICD-9). A HCFA 1500 or UB92 form is preferred. Pharmacies should attach an RX label.
The pink copy must have the medical/lab report attached. Pharmacies should attach an RX label.
The light yellow copy is for your records.
Should the goldenrod copy or white copy still be attached, please mail it back to MHSI - Attn: Betty