Medication Nurses

[medfills]

Hello,

I have a question. I have started a business about two years ago that I have been quite successful at. I am an RN and I have made contracts with clients in my community for help with medication management, that includes things like filling their pillboxes on a semimonthly or monthly basis for a privately paid fee. I am, however, not very knowledgeable regarding insurance reimbursement, and regulations. By the way, I live in Florida.

I feel that if I were to be able to be reimbursed by insurance, that it may provide a larger customer base, especially for those individuals that have difficulties with payment.

My questions are as follows:

1. Has anyone ever heard of insurance reimbursement for this basic type of business?

2. Does anyone know if it would benefit me to make my business a PRIVATE nursing business? For example- get licensed as a private nursing business within my state?

3. Does anyone know if Medicaid or Medicare B would pay for these services? (I know that Medicare A pays for home health businesses that are Medicare certified, but that it will not reimburse "maintenance medication management" which is basically what this is)

4. Could I convert my business to a HOME HEALTH AGENCY focused on medication management only? Or would I need to have therapy services, etc.... for home health licensure....?

Any ideas/answers would be highly appreciated:) Thank you for the time!!

[Selfie]

Does anyone know if Medicaid or Medicare B would pay for these services? (I know that Medicare A pays for home health businesses that are Medicare certified, but that it will not reimburse "maintenance medication management" which is basically what this is)

I don't think so. Medicare has very strict guidelines. You would need a doctor's order just to go into the house to fill the mediset. I discharge patients from the hospital, and I am unable to set up home care for mediset fills only. We are able to teach the patient/family in the home. There must be a skilled need for home care services. FYI- Some pharmacies will do this for patients, and I think more are beginning to participate.

Could I convert my business to a HOME HEALTH AGENCY focused on medication management only? Or would I need to have therapy services, etc.... for home health licensure....?

I wouldn't think so, considering medicare guidelines. I think you would need to find some skilled needs. Medicare wants HOMEBOUND patients, or they won't reimburse.

[Succubus]

I have worked for a company that only did med set up and diabetic foot care. They were being paid by medicare? or medicaid? I dealt only with a certain demographic. The only order that we had was the medication order. We weren't allowed to change any medication unless we had a DRS ORDER.That was faxed to the case manager before. However, we were able to verify medication IF we were able to get an answer.