How do I become a self-employed nurse in California?

caliotter3 · Jul 12, 2009

One of my former clients employed nurses independent of home health agencies to fill in the gaps that the agencies were not providing for. She paid them out of pocket. My supervisor on the case told me about this because she was working the case for the agency and also working private duty at the same time. When the case changed agencies and they could provide even less nurses than were previously available, I also started doing private hours for the client. It was easy for us because the client had her CPA cut our checks and he took out all of the employment taxes. Some time after I left this case altogether, my former supervisor told me that the insurance company that was paying for the agency portion of the care, decided to dump the agency. She continued on, except now the insurance company was paying her. No more agency middle man. (But, she didn't get a pay raise.)

I can empathize with your client's and your opinion of Maxim. Your client will have to really raise a stink with the insurance company long and hard, and have justifiable reasons, to get Maxim out of the picture. It is difficult, but it can be done. In the case I was talking about, it didn't happen until the insurance company came up with the idea itself, for it's own selfish reasons. If I were you though, I would tread lightly with Maxim, or any other agency that has a monopoly on the area work. You don't want to ruin future chances to work for them because you never know what may happen in the future. As long as you are forced to deal with Maxim, just be careful to always watch your back and expect the worst of treatment from them if anything bad happens.

Darlene Hudson BSRN · Nov 1, 2011

Considering self employed and possibly add others later on. How can I educate myself on establishing clients and set up process for documentation, getting paid, taxes and how do I get 3rd party status to get paid by insurance companies?

I am in Oregon, BSN RN pediatric nurse, highly experienced with newborn and medically fragile children, and Parish Nurse.

SDALPN · Nov 2, 2011

There must be an agency around there that would take your case. The agencies are very competitive. You can take the case to another agency and get a referral fee. You can sometimes name your price if the parent will work with you. You tell the agency you aren't going to them unless you get xx for pay.

Be careful because some agencies have you sign something saying you won't work for the patients family for 120 days or whatever. Its not worth the paper its written on. But they could give you a little trouble for it.

I don't know much about this...but I have heard of families getting the money from the ins company to find and hire a nurse. Then the nurse is paid by the family instead of the insurance company. I know one guy who pays his nurses well and keeps some of the money to pay for his nurses to have insurance benefits. But I have no idea how all of that works.