Become Medicaid/Medicare provider

Specialties Private Duty

Published

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

Specializes in Peds,, Home Health, some geriatrics.

can you bill medicare and insurance companies?

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can you bill medicare and insurance companies?

i don't know about medicare at all - but yes to insurance companies - i think you would use your npi# & then apply for an id# thru the insurance co that the family is using. i only know this because i almost took a private case that was paid by insurance - not medicaid.

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Specializes in Rehab, Geriatrics & School Nurse.

Can someone tell me how to apply for GA? Or where to start googling

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Specializes in Peds,, Home Health, some geriatrics.

I've been an LPN independent provider in Ohio for 11-12 years. LPN's make the same as RN's. I can only bill Medicaid. I "think" Indiana has the same IP program, Florida and it sounds like Wisconsin does? It also appears Calif will let Rn's bill medicare and insurance company's as well. But I know nothing more about that.

Nurse practioners can bill medicare and insurance in Ohio but not Rn's.

If anyone know's more or something different let me know.

I'm an RN now and I'm getting out of the medicaid IP work for various reasons. Tired of paying all my own taxes, need benefits and just need a change. But it was good money for a long time. There use to be no competition and now it's crazy. LPN's have moved to Ohio because of this reason. It's very hard to find IP cases now. Plus home health business is booming in Columbus!!!!!

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There is lots of info for wisconsin nurses at http://www.professionalhomecareproviders.com

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Specializes in Peds,, Home Health, some geriatrics.

That's great to know more states do this. It's getting harder and harder to find cases in Ohio. They're changing how you bill and who manages cases. Plus there's too many nurses in Columbus. They're training aides to pass meds in home a well. Lot's of changes and cut backs in medicaid pay in Ohio too. It will be so interesting to see where this all leads.

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I have my NPI number and am an RN in Ohio. Is medicaid my only option for reimbursement and not medicare?

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Specializes in Peds,, Home Health, some geriatrics.

That's correct. You have to be an agency to bill Medicare and be OSHA and JAccho certified etc. Unless there is something I don't know.

I think NP can bill medicare, which is where I see the new healthcare going. NP's doctor's work for 1/2 the cost

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Specializes in Medical surgical.

Call up the Department of Social Services in your state, ask for the supervisor of the private duty nursing program. How this works is, after you have obtained your NPI # by goggling up emedny.com, fill out the application for private duty nurse. and NPI #(your id with the state), then call that supervisor for your county, and leave your name and availability with her. Give weekly calls. You will be taking care of pts. in THEIR HOMES, one pt, adults in ny = 36.05/hr, Peds. 43-4/hr. You are totally on your own, so experience helps, you work directly/report to MD, a visiting nurse checks the pt. out every 6 mos., GET MALPRACTICE INS., you bill directly to the state, pay your own SS/Taxes, no benefits, get your own health ins., call your own hrs., very flexible with the families UNLESS IT IS A 24HR. CASE THEN, IT WILL BE 12 hr. shifts, etc., 8 hr. if the nurses decide, work as many hrs. as you like, i have been doing it for years. any questions.

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Specializes in Medical surgical.
That's great to know more states do this. It's getting harder and harder to find cases in Ohio. They're changing how you bill and who manages cases. Plus there's too many nurses in Columbus. They're training aides to pass meds in home a well. Lot's of changes and cut backs in medicaid pay in Ohio too. It will be so interesting to see where this all leads.
You have to call the nsg. supvr. frequently to get cases, they like to go to the agencies first.
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Call up the Department of Social Services in your state, ask for the supervisor of the private duty nursing program. How this works is, after you have obtained your NPI # by goggling up emedny.com, fill out the application for private duty nurse. and NPI #(your id with the state), then call that supervisor for your county, and leave your name and availability with her. Give weekly calls. You will be taking care of pts. in THEIR HOMES, one pt, adults in ny = 36.05/hr, Peds. 43-4/hr. You are totally on your own, so experience helps, you work directly/report to MD, a visiting nurse checks the pt. out every 6 mos., GET MALPRACTICE INS., you bill directly to the state, pay your own SS/Taxes, no benefits, get your own health ins., call your own hrs., very flexible with the families UNLESS IT IS A 24HR. CASE THEN, IT WILL BE 12 hr. shifts, etc., 8 hr. if the nurses decide, work as many hrs. as you like, i have been doing it for years. any questions.

Thansk for the info!!!!!!!!!!!!!! those are RN rates, correct?

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Specializes in Medical surgical.

Yes they are, you just have to keep calling, fillin if necessary. Also texas have 25 openings on Linkedin.com if you know anyone that want to relocate there.

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