NY Medicaid Provider LPN, needs answers

  1. 0
    Hello everyone,
    I stumbled upon this site while researching info on medicaid provider lpn's. I'm an LPN who recently became a medicaid provider, but I have no idea where to go from here. I have 3 years experience in home care, both adult and high-tech pediatric. I currently work through an agency who robs me blind! I have a pediatric patient who has an RN accompany him to school through the board of ed, and she is an independent contractor. I was told by the pt's mom that the RN was working for the same agency I work for and she became an independent contractor and basically swiped the case from them. Eversince then, the agency refuses to find coverage for the patient if he doesn't go to school, because the daytime hours now belong to the RN, as the independent contractor. I would love to have the evening hours as an independent contractor, but that would have to be approved by the parent, and given te situation with the agency right now, she is afraid to give them up and allow me to bill medicaid directly because she thinks the agency will not provide coverage in the event that I can't make it for any of my shifts.

    My real question here is to anyone who does this type of work in NY. How do I go about obtaining a private duty case where I can bill medicaid directly as an independent contractor, and not through an agency??

    I have a 2 yr old child who will be going to school in september and I want to be able to drop him off and pick him up, instead of having him ride the bus at such a young age. This was the reason why I became a medicaid provider. I figured I wouldn't have to be at work at 7am, like the usual start of a day shift, and I'd be better able to juggle my career and family responsibilities. I just do nt know how to find a case that i can call my own. Anyone with info, please help.

    Thanks in advance.

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  2. 13 Comments...

  3. 0
    http://www.osc.state.ny.us/audits/al...3000/99s16.pdf

    I am not positive if the above site will be helpful to you or not it does address Medicaid and billing . I am not positive if it address how you would go about becoming a private duty LPN able to bill for your own hours. It does say you would be under the individual patients doctor. So perhaps that would be what one would have to do. Contact their doctor.
  4. 0
    http://www.emedny.org/ProviderManual...icy_2006-1.pdf

    I think this site might be helpful.
  5. 1
    http://www.emedny.org/info/providere...lpn/index.html

    Enrollment for fee-for-service is only appropriate for home care providers.
    If you are a nurse applying for Medicaid enrollment and are employed in a
    physician's office or hospital you are not eligible for Medicaid reimbursement.

    All business matters relating to your practice are your responsibility. You
    are self-employed and are not considered employed by the New York State
    Department of Health.

    If you have any questions about our guidelines please refer to the
    Submission Guidelines section of this page. If you have any questions about
    the Personal Privacy Law please review this information at the bottom of
    this page.

    Ok , I am done searching now..
    OneFlyNurz likes this.
  6. 1
    Thanks a lot, but i'm already a provider. I just need to find a patient to take care of lol! I had to read all of that stuff before I applied for the provider number but now I have the credentials and NO PATIENT!! Thanks anyway for your help, I appreciate ur effort.
    lpnflorida likes this.
  7. 0
    Check out the PennySaver and CraigsList for private duty pediatric nurse cases. Also - word of mouth - if you happen to have any nurse friends who have a medicaid provider# & do private duty - you can inform each other of new cases.
  8. 0
    Quote from OneFlyNurz
    Hello everyone,
    I stumbled upon this site while researching info on medicaid provider lpn's. I'm an LPN who recently became a medicaid provider, but I have no idea where to go from here. I have 3 years experience in home care, both adult and high-tech pediatric. I currently work through an agency who robs me blind! I have a pediatric patient who has an RN accompany him to school through the board of ed, and she is an independent contractor. I was told by the pt's mom that the RN was working for the same agency I work for and she became an independent contractor and basically swiped the case from them. Eversince then, the agency refuses to find coverage for the patient if he doesn't go to school, because the daytime hours now belong to the RN, as the independent contractor. I would love to have the evening hours as an independent contractor, but that would have to be approved by the parent, and given te situation with the agency right now, she is afraid to give them up and allow me to bill medicaid directly because she thinks the agency will not provide coverage in the event that I can't make it for any of my shifts.

    My real question here is to anyone who does this type of work in NY. How do I go about obtaining a private duty case where I can bill medicaid directly as an independent contractor, and not through an agency??

    I have a 2 yr old child who will be going to school in september and I want to be able to drop him off and pick him up, instead of having him ride the bus at such a young age. This was the reason why I became a medicaid provider. I figured I wouldn't have to be at work at 7am, like the usual start of a day shift, and I'd be better able to juggle my career and family responsibilities. I just do nt know how to find a case that i can call my own. Anyone with info, please help.

    Thanks in advance.
    Hello, I understand that this post is old, but after I have been an LPN for almost two years for home care, I have just become a NY Medicaid provider as well. (I just got the congratz letter today) I want to be able to do this just until i get my RN and be able to spend more time at home with my kids in the mean time. the agency i work for pays me peanuts($$in the teens$$) for doing the same work. I was wondering if you were able to get your own cases, are you able to make a decent living from it and how did you do it? I was thinking about advertising in the internet. thanks for any replies, any advise will be greatly appreciated.
  9. 0
    I see some people advertise on Craigslist.
  10. 0
    Greetings I know its been a long time since you've posted about the private duty cases but iwould like to know if you had any luck. I'm just starting my process with the NPI and Medicaid Number but wanted to know where can i look for cases besides craigslist and pennysaver. Lpn jobs in ny are hard to get and when you do get one they are robbing you blind like you said. SMH. Any pointers would be helpful



    Quote from OneFlyNurz
    Hello everyone,


    I stumbled upon this site while researching info on medicaid provider lpn's. I'm an LPN who recently became a medicaid provider, but I have no idea where to go from here. I have 3 years experience in home care, both adult and high-tech pediatric. I currently work through an agency who robs me blind! I have a pediatric patient who has an RN accompany him to school through the board of ed, and she is an independent contractor. I was told by the pt's mom that the RN was working for the same agency I work for and she became an independent contractor and basically swiped the case from them. Eversince then, the agency refuses to find coverage for the patient if he doesn't go to school, because the daytime hours now belong to the RN, as the independent contractor. I would love to have the evening hours as an independent contractor, but that would have to be approved by the parent, and given te situation with the agency right now, she is afraid to give them up and allow me to bill medicaid directly because she thinks the agency will not provide coverage in the event that I can't make it for any of my shifts.

    My real question here is to anyone who does this type of work in NY. How do I go about obtaining a private duty case where I can bill medicaid directly as an independent contractor, and not through an agency??

    I have a 2 yr old child who will be going to school in september and I want to be able to drop him off and pick him up, instead of having him ride the bus at such a young age. This was the reason why I became a medicaid provider. I figured I wouldn't have to be at work at 7am, like the usual start of a day shift, and I'd be better able to juggle my career and family responsibilities. I just do nt know how to find a case that i can call my own. Anyone with info, please help.

    Thanks in advance.
  11. 1
    Hi, I've been doing the private duty home care ffor a while now on n off but its been the same, craigslist or pennysaver or word of mouth from other nurses who might be on a case that needs more nurses. I actually went back to the nursing home and also back to school, just completed Excelsior College's nursing program and getting ready for nclex. It's too tough out here for lpns.
    Miaizon likes this.


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