What is one reason Medicaid is considered the payer of last resort?

Prepare for the Certified Billing and Coding Specialist Exam. Improve your skills with multiple choice questions; each question comes with hints and explanations. Get confident for your exam!

Medicaid is considered the payer of last resort primarily because it is designed to provide healthcare coverage to low-income individuals and families. This means that before Medicaid pays for any healthcare services, other sources of payment must first be exhausted. This could include private insurance, Medicare, or other public programs that provide financial assistance for healthcare costs. The intent behind this is to ensure that Medicaid serves its primary purpose of supporting those who may not have the means to afford healthcare otherwise, without unnecessarily depleting its resources by being the first option for payment.

While the other options do mention aspects that may relate to Medicaid, they do not capture the core principle of the program's functioning as the payer of last resort. For instance, Medicaid does not only cover emergency visits, it's not universally subject to prior authorization for all services, and it does not strictly limit coverage to catastrophic events. These factors do not define the fundamental aspect of Medicaid's operational framework as much as its role in prioritizing coverage for the financially vulnerable.

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