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

[Kez0507]

Thanks Brian for your reply, I can use all the help I can get :)

[luv4nursing]

How would I go about becoming a provider in TN? Our system is called Tenncare here. I did private duty peds through an agency for a few years as an LPN and now Im an RN. My husband is in LPN school. I thought when he finishes we could both become providers.

[sunrock]

You have to get in contact with the dept. of social services, public health nursing dept., and take it from there. Also check out your peds., hospitals, and get hold of a social worker , you may have a little problem with that, unless you know someone at the hosp. , let me know how you made out.

[tmassie]

I am an LPN and am wondering how to go out on my own. Don't I need to have an RN sign off on my paperwork?

[tmassie]

I have been a nurse for over 20 years. 18 of that is home health. I was working as an occupational nurse for the past 11 years then d/t cut backs my department was closed. Ever since that time I have been unable to find full time employment. That is why I thought about going out on my own.

[sunrock]

You do not need a supervisor to sign off on your notes if you work direct with the dept.l of ss, the public health nurse visits quarterly, and now you submit your notes as requested by them. If you work thru an agency, again public health nurse comes quarterly for dept. of ss, and monthly notes are sent to agency monthly, of course as you know you make much less thru an agency, good luck.

[CloudySue]

I'm not quite sure I completely understand what I'm reading about here. Am I to understand that an individual with any type of nursing license, including LPN (which I am), can get their own number to be a direct provider of nursing care in a home, under the direction of the client's MD, and collect the full hourly fee from private insurance companies, Medicare, and Medicaid? So essentially I cut out the middleman, the agency, and collect the full amount that an agency would before they cut me my check? If this is correct, I would have to find my own clients, but then once I work everything out with them, I start? How would I market myself? Craigslist can get quite shady. If I get lots of business, can I have employees? (I know that's getting ahead of myself here, but I'd like to know if there's growth potential in this.) Thank you!

[sunrock]

@cloudy sue: I was referring Medicaid only. Yes if you get the client and it OS approved got Medicaid, you cut out middleman. Private companies do not know about us. B cause no one markets private nursing, it would put others out of business. Agencies take a1/3 of our pay with no benefits, having said that nursing will be changing to alternative care shortly.

[caliotter3]

My former supervisor was paid directly by the insurance company when they dumped the home health agency. Although the middleman was cut out, she divulged to me that she received no increase in pay at all. So, you can not assume that you will always get a better rate of pay.

[sunrock]

At cloudy sue: ok'd, you can register with local Medicaid office. Put ad in papers, word of mouth. ,

[bradysgang32]

medicaid provider number nys application

[sunrock]

As mentioned you can register on line for Medicaid # and npi #, not sure what your ? Is