private duty home health care

  1. My employer is considering private pay private duty through the home health agency she owns. How does private duty work when it is through home health agencies? :uhoh21:
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  2. 6 Comments

  3. by   renerian
    Usually a client wants private duty/private pay most of the time and they can get mostly what they want to pay for. Some insurance companies will hire hourly staff.

    renerian
  4. by   jrenae
    Quote from renerian
    Usually a client wants private duty/private pay most of the time and they can get mostly what they want to pay for. Some insurance companies will hire hourly staff.

    renerian
    Thanks renerian,
    We are concerned about Medicare and like kind services. Medicare states that you must charge an individual the same amount you charge them for like kind services, bathing, med assistance etc. If you have any info on this I would greatly appreciate it.
  5. by   NRSKarenRN
    Must be set up as two seperate companies with dedicated office space just for private company.
  6. by   MEL101
    The last agency I worked for billed either the patient who in turn was reimbursed by their Ins. company or the insurance company paid after negotiating a charge(s) for services rendered. On admit the RN still filled out an OASIS but for info only...we did not follow medicare guidelines for private pays.
    If the private pay was HMO or PPO the agency case manager called for a PA#
    (prior auth) or reference # (used for billing purposes) and updates on pts progress every 7-10 days or so to case mgr of ins company. They in turn may request E-Z graphs or written/computer documentation which would assist them in justifyin more visits for x days etc...The agency made lots of $$ on private pays....hope this helps...
  7. by   renerian
    How is your agency structured?

    renerian
  8. by   jrenae
    I work for a subsidiary of the home health/hospice agency, called medical staffing resources. It is a separate company, but with the new regs in TN you can not do baths without either being home health or have a PCSSA license. If you have the PCSSA license you can't do any type of medication assistance. This is why we are questioning private pay through home health.
    Thanks for all of the replies.

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