New PICC Line Service

[JustWe6]

4/15/14 My company is starting up a new PICC Line service in our small rural area. WE NEED HELP with a "written contract with our medical facilities", and we need to know the "average charging/fees for PICC insertions". I have asked numerous companies but no one is willing to share. We are a nursing owned company and would greatly appreciate your help.

[traumaRUs, MSN, APRN]

Moved to Entrepreneurs in Nursing

[NedRN]

A Google search for Medicare PICC reimbursement is easy: the first hit should be very helpful (Medicare outpatient PICC insertion is reimbursed at $500). Do you have health insurance? Your insurance company will tell you what their reimbursement will be if you give them a diagnosis and hospital. While I'm not in your business, I can tell you that hospitals I call are very happy to tell me what bill rate they want to pay. More than half the time, I'm very happy to accept their "average" rate and have no need to negotiate.

I would think a big question is if you will be a third party biller to insurance companies and Medicare/caid, or to the facility. If to the facility, I would think your fee for service will be at least 10% less if not more. In any case, your maximum rate will be determined by what the facility can be reimbursed.

Contracts are much easier than anyone thinks. Use the synonym agreement for less stress. Simply describe what you provide and your responsibilities. Similarly describe the facilities responsibilities. You can include a fee schedule if you want (probably better as an addendum), and describe things like insurance coverage and workers comp. After several years in business I had to take a hospital to court and added a couple sentences about legal proceedings to help avoid similar cases. Yet my contract (for travel nurses) is still less than two pages and is usually accepted without modification. In your business, your only legal issues will be billing, and insurance coverage in the case of an adverse outcome. Neither one is worth 10 pages of boilerplate.

As mentioned in the other thread, some hospitals may have their own contract. Insurance companies certainly will. It simply is not that important in starting your business. Finding work is 99% of new startups usually.

[CapeCodMermaid, RN]

Our pharmacy charged $600-$700 to come out and out in a PICC or Mid line. Frankly we got tired of paying so we had a few of the RNs trained to insert them in-house. It's saved us tons of money and the patients are more comfortable because they knoe the person inserting the PICC. We are the only SNF in the area that does this.

Good luck with your new endeavor.