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

I am very interested in how to get started as well. Your post was VERY helpful! I will continue to follow this thread in hopes that we can get more detailed information.

thanks!!

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OK...How do I find the info for a provider number? I thought the NPI was it. Oh well, onward with the search! Thanks for the support and feedback.

Joy

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OK...How do I find the info for a provider number? I thought the NPI was it. Oh well, onward with the search! Thanks for the support and feedback.

Joy

You need to call customer service at emedny - if of course you live in NY - otherwise you need to find the website for your state. http://www.emedny.org/

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OK, I finally found a number for Medicaid through the Dept of Human Services in Illinois. I am being mailed forms to fill out to get a Medicaid provider number. I also contacted Medicare and was told that an RN can not get reimbursed by Medicare "at this time." A nurse practitioner can. The lady I spoke to is also sending me a handbook explaining billing, etc, which she said is often times not sent if you don't ask.

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For anyone who is already getting reimbursed by Medicaid: what kinds of services does Medicaid pay for? I am planning to get the handbook in the mail with my appication for a provider number, but if I can get an idea what services I can advertise, I can start working on advertising and marketing.

Thanks

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For anyone who is already getting reimbursed by Medicaid: what kinds of services does Medicaid pay for? I am planning to get the handbook in the mail with my appication for a provider number, but if I can get an idea what services I can advertise, I can start working on advertising and marketing.

Thanks

You can reply to the ads in the PennySaver or Craigslist for RN'/LPN's with a medicaid provider number. I've only seen children or young adults - homecare.

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I am in Illinois. I applied for and got an NPI number. As posted previously, I contacted the State Medicaid provider office and asked if I could apply to be a provider as an RN, not an advanced practice nurse, and was told I could and they would send me an application packet. I received it and began filling it out and could not find a provider code for RN, so I called them. I was told in the phone call that as a "plain" RN I can't be a Medicaid provider, and there was no code for just an RN. I looked back on the Medicaid website for IL and found a code for an RN and called them back. They said they had that code crossed out on their provider list. So I don't know if at one time they did allow RNs to be providers, and now, for some reason have taken that away, or if there is a mistake that I have to get to the bottom of. I called back again to try to get to the bottom of things, and asked to speak to someone who could enlighten me. I was told the supervisor was not at her desk, and they took my number. I have not heard back yet, and will call again today. Does anyone have any insight into being a Medicaid provider in Illinois as an RN, not nurse practitioner or advanced practice, so I can do private duty and get reimbursed by Medicaid? Maybe it varies from state to state. Thanks - Joy

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I am in Illinois. I applied for and got an NPI number. As posted previously, I contacted the State Medicaid provider office and asked if I could apply to be a provider as an RN, not an advanced practice nurse, and was told I could and they would send me an application packet. I received it and began filling it out and could not find a provider code for RN, so I called them. I was told in the phone call that as a "plain" RN I can't be a Medicaid provider, and there was no code for just an RN. I looked back on the Medicaid website for IL and found a code for an RN and called them back. They said they had that code crossed out on their provider list. So I don't know if at one time they did allow RNs to be providers, and now, for some reason have taken that away, or if there is a mistake that I have to get to the bottom of. I called back again to try to get to the bottom of things, and asked to speak to someone who could enlighten me. I was told the supervisor was not at her desk, and they took my number. I have not heard back yet, and will call again today. Does anyone have any insight into being a Medicaid provider in Illinois as an RN, not nurse practitioner or advanced practice, so I can do private duty and get reimbursed by Medicaid? Maybe it varies from state to state. Thanks - Joy

Joy,

hi - i'm in NY & don't know the answer to your question - but I work as an LPN as a medicaid provider - so what you are saying doesn't seem right at all. An advanced nurse practitioner doesn't do the type of homecare that a "plain" RN or LPN does. Definately keep calling to get to the bottom of this - tell them it's just homecare you want to do - check out the PennySaver (do you have that in Illiniois - we do in NY) or Craigslist to see if people are looking for RN's/LPN's with a medicaid provider for homecare - if you do see those ads then the info you're getting for some reason is wrong. Good Luck! Lisa

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I got a call from Medicaid and was told that in Illinois one has to be an advanced practice nurse "with additional credentials", they expect more training that other states. Interestingly our governor was impeached last year for trying to sell President Obama's Senate seet when he became President, as well as other misconduct. Interesting, different standards, I guess.

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I got a call from Medicaid and was told that in Illinois one has to be an advanced practice nurse "with additional credentials", they expect more training that other states. Interestingly our governor was impeached last year for trying to sell President Obama's Senate seet when he became President, as well as other misconduct. Interesting, different standards, I guess.

This just doesn't sound right - what about homecare - trach care, giving meds via G-tube.... - there is NO homecare in your state??? They surely don't pay AP nurses to give regular nursing homecare.

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There is homecare, but Medicaid won't pay for independent private duty nurses (RNs or LPNs) who perform skilled care. I believe from what I read that, of course, if you work for a home health agency Medicaid pays them for the allowable services, but then that's not private duty.

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I work in Private Duty/Home Health nursing and I just LOVE it! It is one of our best kept secrets :nurse: I live in Wisconsin and our website to obtain your provider number and info is http://www.forwardhealth.wi.gov

Kim

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