Case Manager Pay - page 2

The company that I work for pays RN Case Managers per visit. Unless the visit is to open a new client, we get paid for one and a quarter hours per visit. The Case Managers do the skilled visits and... Read More

  1. by   Pooksmom1996
    Quote from Kyasi
    If you love the job, stay with it...

    I do have to respectfully disagree with you though... if they weren't making money, they would fold. I do the monthly billing for my branch office and I'm astounded at how much they really do make. It's staggering.

    I am curious, Kyasi-how much reimbursement does your company generally get from insurance for RN visits?

  2. by   Kyasi

    Sorry to be responding so late. Lots of things going on right now.

    First, let me say, I work for a Medicaid only agency, so I can't speak to what Medicare or insurance reimbursement is.

    I would say the biggest money maker for a Medicaid agency is Prior Authorizations where the per hour reimbursement is $18.34/hr for a HHA, $25.01/hr for a LPN, and $37.36/hr for a RN. I'm sure this varies from state to state. The biggest reimbursement is the 'overhead' where they pay $34.30/day of service. So if the agency is paying roughly $9.50 - $10.00/hr for a HHA, $17.00 - $18.00/hr for a LPN, and $22.00 - $23.00/hr for a RN, you can see the profit.

    So an example would be: let's say we provide a HHA 10h/day, 7 days per week. Reimbursement will be is $1,283.80 + overhead $240.10 = $1,523.90/week. If the average HHA pay is 9.75/hr, the pay out is $614.50/week. Toss in there minimal benefits and a very small travel reimbursement and you can see in a years time that there is a big profit. But then you do have to take into account the nursing staff who does the paperwork to obtain this funding and who do the needed start of care and follow-up visits with the clients. That's what the overhead pays for. But obviously, there is profit or the company would fold.

    Maybe someone else has some figures for insurance or Medicare.

  3. by   msslim
    Gosh twinpumpkin where are you? I need a job there!!!!!
  4. by   cny4rn
    From what I can tell the point system only benefits the company. I started about two months ago for a company that uses it and gave a two and half week notice this week. We are reimbursed at 1 point for regular SNV, 1 point DC, 1.5 for RC, 2.0 for ROC, and 2.5 for SOC. My point system is worth 41 dollars per point for me. I don't know what the other RNs are worth. We do get mileage at 40 cents per mile. This sounds pretty good at face value but we have a PDA computer system called HCHB and it is very repetitive and takes more time than paper.I spend time at home charting probably 5 hrs a week, after long days.Maybe I'm just burned out after this scorching Texas summer heat and getting in and out of a hot car. Pun wasn't intended! I have been in home health over the past 15 years part time and full time and paper just seemed better to me. Is anyone else familiar with the hchb computer system?
  5. by   kicnic
    hchb= terrible, charting on a pda= more terrible!!
  6. by   cathrn64
    I agree HCHB is terrible
    The PDA is making me go blind!!!!!!!! (print is too small)
  7. by   MindyTX
    Hey cathrn64, I also struggle with the small screen and print. Our agency added a device called "red fly". It looks like a small laptop but it is actually just a screen and keyboard. It is lightweight and connects to the PDA via a cord. Easy to take into a home and if you prefer a keyboard. you can rip through narrative documentation.
  8. by   Care Plus
    Hi Kyasi,

    I took over a company that is very much like what you describe here. What I found is that the Case Manager spend lots of hours doing their paperwork. Their non-billable hours are close or sometimes higher than their billable hours. Even I am paying some of them only $25.00/hr, it is still a lose to me. Unless I limit their paperwork hours down.

    Does the company you work for has any policy on how much time they allow the Case Manager to use?
  9. by   lbratcher
    We are a salary company. Salary is M-F 8-5. After hrs visits are $60.00, SOCs and ROCs are $160.00 on call. Full federal mileage allowance on a separate monthly check. Expectation 5 visits a day. Oasis count as 2.25 visits for productivity monitoring and mileage/travel time figure into this. Aversge salary $70,000
  10. by   April5293
    Great input....where are you? I want to come work for you :-)