Home Health....do I need agency?

[UCTxNurse]

I was wondering does a nurse need to have an agency to work a private pediatric case? I currently am working as a private pediatric nurse for 1 child. My agency is paid by Medicaid who then turns around and pays me my hourly rate. I have heard that a person could actually be a persons nurse and then bill medicaid directly, is this true?

[caliotter3]

The private duty cases I worked were private pay by the client's family. I would contact the medicaid people for an answer to your question. I know that certain categories of workers can do that but it is a complicated process. Probably the reason why more people don't do it. Home health agencies would not be in business if it were easy to bill the payors.

[pagandeva2000, LPN]

I would rather deal with an agency, myself. I did hear that we can register or arrange to be providers, but, I do believe it would be a complicated process, and would rather not deal with it.

[caliotter3]

One of my friends went independent contractor with the insurance company and was not happy with the process. She was expecting a raise in pay with the middle man agency removed from the equation. Otherwise, she said she was not happy with dealing with the insurance company. She was not happy dealing with the agency to begin with, but found that dealing with the insurance company was worse. I could only imagine that dealing with govt agencies would compound the headaches. I would not work in such a situation. JMO.

[Memerson2000]

I'm a Medicaid provider in NY; have been for many years. We just got a thirty percent increase (up from 30.90/hr) for medically fragile peds cases; it's a good deal. I stopped working for the agencies about 12 yrs. ago. The billing was tricky--six weeks wait for a check, and that's if you didn't make a mistake on the rather complicated invoice--but it's gotten easier over the years--it's computerized now, and if there's a problem, I know right away and can keep fixing the invoice until it's accepted. You have to pay self-employment tax, but your business deductions can allow you to deduct much more than you would if you were an employee. Don't let the naysayers get you down.

I'm not sure how you get on board; I kind of stole my first case from the agency--they would leave the patient unstaffed rather than pay me overtime, so I felt like they violated the contract first--some shifts were already covered by a provider, and that nurse walked me through it. Then I got the number of a case manager for peds patients (Maybe your department of social services would have that?) and she tipped me off to other families who were looking.

Keep trying--there are families out there who really need nursing, and the agencies just aren't cutting it.

[Angela11]

Would you mind giving me your contact information? We are 2 RN's looking to become a medicaid provider for home health care in Maine. Thanks!