Become Medicaid/Medicare provider

[JM3RN]

Hello,

I am new here. I am in the process of planning my own business, either home care (private duty) or care manager (I just became aware of this title; is anyone familiar with it?). I read in an old post that a nurse became a Medicaid/Medicare provider and apparently was able to use those resources as sources of payment. Does anyone know how you become a M/M provider? And, how fast do you get your payments from them?

Thanks

[JM3RN]

Lacourty, what state are you in, and what is the health department you are referring to - the Department of Public Health? Are you an advance practice nurse? I searched Illinois sites and I'm pretty sure I would only qualify for M/M reimbursement if I were a Master's level nurse practitioner or clinical nurse specialist, which I'm not. I have an ADN. Thanks

[Lacourty]

3M3RN, you don't have to be advanced practice. Minimum requirements for state of Wisconsin is an LPN or RN license. You may want to check out www.prefessionalhomecareproviders.com. They have info on getting certified for Medicaid/Medicare. I am not sure about how to get Medicare certified or if it is even possible from private duty nurses to get Medicare certified. All directions for how to get Wisconsin Medicaid certified were found on www.forwardhealth.gov.wi. I am still in the learning process as well. Sorry I couldn't be of more help.

[Nurse_Re]

http://www.emedny.org/

This is the website for New York & is where you begin the process of obtaining your medicaid provider number so you can be reimbursed thru Medicaid. The pay is excellent - but you have to remember to take out quite a bit in taxes since it's your own business. I personally think this is one of nursings best kept secret.

A quick question, after I submit my application to NY what's is my next step, and how to you stay on top of taxes and other contributions (SSI, Medicare ect.)

[Lisa1203]

a quick question, after i submit my application to ny what's is my next step, and how to you stay on top of taxes and other contributions (ssi, medicare ect.)

you have to take out taxes on your own. it all depends on your financial circumstances - i take out 37% (yes - that high) & immediately transfer that into a savings account i opened up for that very purpose. & as far as your first question - the next step - well- there are many steps - you need to call the customer service number for emedny - they'll tell you. it's all a pain in the butt - but totally worth it.

[Nurse_Re]

thank you for the pointers!!!

[nickynoodles]

this sounds so interesting...Im anxious to hear more about it

[Nurse_Re]

Did you create your own progress notes, or does NY specify what they want? Did you ever have to mail them to NY state?

[calmcool1]

I'm a medicaid provider in Ohio, the website is www.ohiohcp.org. Also my friend is a provider in Texas and thier website is www.tmhp.com. I hope this is helpful!

[tleigh7097]

Anyone have pointers for Illinois?

[JM3RN]

Hi, I'm from Illinois. I just did a search, compliments of a previous post on "NPI." I found this site - National Plan and Provider Enumeration System (NPPES) nppes.cms.hhs.gov. I was able to apply for an NPI there, and it will be processed. I hope this helps. It wasn't as impossible as I thought.

Joy

[JM3RN]

I just got my NPI! Check the time from my last post! Now what do I do, see what services Medicaid will cover and advertise those (of course within my training and scope of practice? Does anyone know how to get started? This seems like a big deal to me to get the NPI.

Joy

[Lisa1203]

I just got my NPI! Check the time from my last post! Now what do I do, see what services Medicaid will cover and advertise those (of course within my training and scope of practice? Does anyone know how to get started? This seems like a big deal to me to get the NPI.

Joy

Actually, now that you have your NPI # you can apply for your medicaid provider # & THEN you can look for work - isn't it complicated!