How to do skilled visits independently and bill Medicare

[PeacefulHeart]

Hello....I am seriously doing some intensive work on transitioning out of my current situation in geriatric care. I absolutely hate it and since I have been in it for about 4 plus years all of the resumes and applications that I am putting out to the hospitals seems to get ignored. I am feeling that the hospitals think that geriatric nurses are not "worthy" or something, but after 13 years in the hospital and working in Critical Care with my CCRN previous to the geriatric stint, I do feel that more attention should be given to me. However, maybe this is a nice little sign that I am being sent to finally do "my own work" and move on. I recently did start my holistic health-wellness business this past Fall, but it is not enough currently to do that on a full time basis.

I also love to teach, all sorts of things with holistic health and disease process, but do not have a BSN and no desire to pursue one.

I am wondering if anyone here would know how to get involved with doing independent skilled visits and then bill Medicare as allowed? I know that there are some home care agencies that do this and pay RN's like 45 per visit. I have researched and heard that Medicare pays them at least 100. So you can see how beneficial it would be to x out the middle man and do my own thing. I do realize that I would be responsible for my own documentation and supplies, although I think most supplies should be covered FOR them through Medicare.

Any advice is Greatly appreciated! I am so ready to get out of working for others!

[RNentrepreneur]

To find information on becoming a Medicare certified agency you can go to http://www.cms.hhs.gov/CertificationandComplianc/06_HHAs.asp. You will find some of the information you will need such as some of the forms you will need to complete, who must be on your board, some of the policies and procedures you will need to have in place and information covering other aspects of certification and compliance.

[PeacefulHeart]

Thanks for your post. I was looking into this just to certify myself, and do the skilled visits since I am a RN.

[RNentrepreneur]

It is my understanding that you must be a certified agency to bill Medicare for skilled nursing visits. Nurse practitioners can obtain a provider number and bill Medicare. However, I do not think that an RN can obtain a provider number. To bill for skilled nursing visits you will need to set up a home care company and get that company certified by Medicare.

[CharlaRN]

I'm an Independent Nurse Provider (RN) with Medi-Cal (California's Medicare). In California, you do not need to be a NP. I needed a certain number of hospital hours in my field (Peds) in the previous two years in order to apply for my INP #.

Medi-Cal needs a Plan of Treatment (POT) signed by the MD and a Treatment of Authorization (TAR) for a patient, and they then give that patient a certain # of billable nursing hours. You take care of the patient, and bill Medi-Cal. About 500years later, they'll pay you (just kidding - but, plan on 6 months from starting the paperwork for your INP to getting your first paycheck - absolutely NOT kidding about that!)

[Ciege911]

Not certain if this is the same, but I have a foot clinic and I obtained my NPI # online from National Plan and Provider Enumeration System. My foot clinic is just a part of the whole clinic-but I bill for my service under my own clinic using my NPI #.

[jwoods09]

Would love to know more about how you were able to get a Medi-Cal Provider number, all the info I have found states have to be a home health agency with oversight by physician and offering at least 2 services (i.e. Home Health Aide + RN)...would love to not have to go through all that red tape!

[merrymmary]

I am an Independent Provider in Ohio and bill Medicaid myself. I get paid 10 days later. What other states have that? Also, what services can a nurse practitioner bill for to Medicare? And also what services can a nurse bill for to Medicare regarding feet?

Thanks, Mary

[chris2732]

It is my understanding that you must be a certified agency to bill Medicare for skilled nursing visits. Nurse practitioners can obtain a provider number and bill Medicare. However, I do not think that an RN can obtain a provider number. To bill for skilled nursing visits you will need to set up a home care company and get that company certified by Medicare.

Hi RNentrepreneur, Thanks for this information. What if you are the only person in the home care company (meaning you own and operate it by yourself, aka, sole proprietorship)?

[zahryia, LPN]

I am an Independent Provider in Ohio and bill Medicaid myself. I get paid 10 days later. What other states have that? Also, what services can a nurse practitioner bill for to Medicare? And also what services can a nurse bill for to Medicare regarding feet?

Thanks, Mary

Thanks. I'm glad someone has finally mentioned Medicaid. As an L and D nurse, I'm clearly not qualified to do Medicare work, but would definitely love to do maternity home health and get a home agency up and running, even if it's just me as an independent RN.

[cheryl123smith]

hi

can someone please give some more info on how and where to obtain the INP #,

how to get started. I am in CA

[CharlaRN]

Go to www.medi-cal.ca.gov and follow the links. You'll need your NPI (National Provider Number) and your INP (Independent Nurse Provider) before you can bill for Medi-Cal patients.