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CharlaRN

CharlaRN

Independent Nurse Provider RN
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  1. Hi again, Susan! Another idea is to go directly to a few hospitals and speak with the Social Workers in NICU and PICU. Once you clarify what you've been doing at home with medically fragile foster children, they can refer a child to you. I haven't heard of a Medi-Cal SW referring a child to an INP - I think a hospital SW may be a better way to go for referrals - especially, in highly populated areas where more children may be in need of qualified RN/LVN foster homes. HTH! Charla
  2. These kids are straight Medi-Cal, and, not Managed Care. Your POT/TAR would NOT go through CCS like Managed Care has to. By looking up their Benefit ID # (BID) on the Medi-Cal site, you can check for yourself that the child is straight Medi-Cal. I do an e-TAR, make a copy of my POT, CPR, RN License, Insurance, Drivers License, and FAX everything over to the phone # on the TAR attachment form (I fax it all) The letter IHO/EPSDT sent out to mail paper TARS/POTS to a new address was confusing - that's only if you DO paper TARS/POTS to begin with! My daughter is doing well! Three years with no Central Line infection!
  3. CharlaRN

    How to do skilled visits independently and bill Medicare

    Go to www.medi-cal.ca.gov and follow the links. You'll need your NPI (National Provider Number) and your INP (Independent Nurse Provider) before you can bill for Medi-Cal patients.
  4. Independent Nurse Providers for California Early and Periodic Screening, Diagnosis and Treatment (EPSDT) are Independent Nurses who provide care for Medically Fragile Foster Children in their own homes; thereby removing children from Group Homes, the hospital, and the Foster Care System, yet providing the necessary skilled nursing needs the child requires. We bill Medi-Cal for the hours that Medi-Cal In-Home Operations, EPSDT approves of for the child (according to California Title 22 Regulations of whether a child meets the description of Subacute or Nursing Facility care). What would be SO helpful is to share our resources, information, ideas, and paperwork strategies with eachother. By pooling resources and putting our collective heads together, we should be able to make it easier for the INP to comply with the Medi-Cal requirements for documentation of our Nursing Notes, Plan of Treatment (POT) and Treatment Authorization Request (TAR). If you, or anyone you know, fit this description of an INP, will you please contact me? I will put you on our list and send you some information that has been gathered so far. It should not be such an isolating experience to be an INP for California's Medi-Cal program. Charla
  5. Independent Nurse Providers for California Early and Periodic Screening, Diagnosis and Treatment (EPSDT) are Independent Nurses who provide care for Medically Fragile Foster Children in their own homes; thereby removing children from Group Homes, the hospital, and the Foster Care System, yet providing the necessary skilled nursing needs the child requires. We bill Medi-Cal for the hours that Medi-Cal In-Home Operations, EPSDT approves of for the child (according to California Title 22 Regulations of whether a child meets the description of Subacute or Nursing Facility care). What would be SO helpful is to share our resources, information, ideas, and paperwork strategies with eachother. By pooling resources and putting our collective heads together, we should be able to make it easier for the INP to comply with the Medi-Cal requirements for documentation of our Nursing Notes, Plan of Treatment (POT) and Treatment Authorization Request (TAR). If you, or anyone you know, fit this description of an INP, will you please contact me? I will put you on our list and send you some information that has been gathered so far. It should not be such an isolating experience to be an INP for California's Medi-Cal program. Charla
  6. CharlaRN

    How to do skilled visits independently and bill Medicare

    I'm an Independent Nurse Provider (RN) with Medi-Cal (California's Medicare). In California, you do not need to be a NP. I needed a certain number of hospital hours in my field (Peds) in the previous two years in order to apply for my INP #. Medi-Cal needs a Plan of Treatment (POT) signed by the MD and a Treatment of Authorization (TAR) for a patient, and they then give that patient a certain # of billable nursing hours. You take care of the patient, and bill Medi-Cal. About 500years later, they'll pay you (just kidding - but, plan on 6 months from starting the paperwork for your INP to getting your first paycheck - absolutely NOT kidding about that!)
  7. CharlaRN

    LLU or CSULB

    I didn't go to either of those schools (I went to LBCC) - however, I worked for 5 years at Loma Linda, and can tell you that the majority of the people in that hospital are just plain nice people - nurses, doctors, RT's, etc. It is a whole different environment mainly because so many there are SDA (not required to work there); at first it was an eye-opener to see doctors and nurses have no problem praying with families or telling a joke that doesn't have to be "dirty" to be funny. I worked PICU, and, even with the stress, the nurses had eachother's back. In my 25 years of nursing, I have to say that I've never met a nicer group of nurses than at LLU. Since you're new, it might not be an issue with you - but, I thoroughly enjoyed (and needed) to be around people who were "just plain nice". Plus - I was pretty impressed with the knowledge base of the LLU Grads.:wink2:
  8. CharlaRN

    PLEASE - need Home Care Flow Sheet samples

    Thanks, Caliotter, This is an audit (like the IRS picking a random nurse to audit). They have an independent nurse consultant who has decided the documentation does not show that the nurse - who billed for the 12 hour shift - showed enough documentation to have them PAY for the 12 hour shift that Medi-Cal has given the child. The auditors are skipping right over Medi-Cal, and going after the nurse based on "not enough documentation" to support her being there for a 12 hour shift. Any Home Care nurse, especially those on night shift, know that there is down time when the patient doesn't require hands-on care - yet, requires the safety of an RN to monitor their status. The paperwork was filled out thoroughly, and done according to Medi-Cal guidelines (which have been fine for 4 years of billing Medi-Cal). Now, the independent audit is looking for "fraud" based on THEIR position that it is not enough documentation to support paying for a 12 hour shift! (Medi-Cal assigned the hours!) Very frustrating - and, a reason I need to gather as many samples of Home Health - even Med Surg - flow sheets to show that there was, indeed, "enough charting" per other Hospital and Home Agency standards.
  9. To make a long story short - a 3rd party is calling 1-2 page Home Nursing flow sheets "fraudulent" as they do not show enough documentation to pay for an 8-12 hour shift worker. Stating that "the care documented could have been done in 3 hours rather than the 12 hours billed", the 3rd party is planning to demand repayment of wages. The patient gets 12 hours of nursing a day through Medi-Cal. The 3rd party issues the checks, and has skipped over Medi-Cal's documentation requirements (which are followed) and is looking at the documentation as being the problem in billable hours. Every Home Care Flow Sheet I've ever seen is basically the same... checks, notations and 1-2 pages long. So, EVERY Home Care nurse faces an uncertain future of being accused of "fraud" by documenting care this way if this is not nipped in the bud. (this is a 12 hour shift worker caring for a Medically Fragile child on TPN with GT feeds and organ failure) Nurses - you know how we see the smoke before the fire.......it is SMOKIN' HOT right now. Please, I need sample forms from any Home Health nurses to show that nursing documentation in the home UNIVERSALLY is done with a check and narration system utilizing one-two pages - it's NOT required for the Home SHIFT nurses to completely rewrite a Nursing Care Plan everytime they do shift work in the home! This is NOT a "visiting nurse", it is a 12 hour shift RN being told this form of documentation is not enough to "prove" 12 hours of care was done! Thank you! attachments can be sent to Chars Funny Farm @aol.com (no spaces) my fax is 1-314-689-8160
  10. I am an Independent Nurse Provider for Medi-Cal. I am in need of any blank documentation forms that you use in a patient's home to show what you've done over a 12 hour (or 8 hour) shift. I have been using my documentation without any problem with Medi-Cal. However, it would help to have samples of what nurses from all over use as documentation of a chronically ill patient in the home. I don't need your company's name, or any identifying logos - and, of course, no patient information. I just need as many samples as I can possibly get over the next few days. Thank you so much! My fax # is 1-314-689-8160 Charla
  11. Hi Kath, I'm an INP for Medi-Cal. You can get patient referrals from Social Workers. If you are currently with a hospital, speak to the various SW there. Also, give a call to Medi-Cal In-Home Operations and put your name on a list so they can notify patients who call that you are available. If you are interested in taking care of a Medically Fragile Foster child, call the DHS in your area. My adopted child was my patient in the hospital, I called the group home, spoke to their SW, and got placement to my home. I provide her nursing care, and bill Medi-Cal. She is on TPN 20hours/day, GT dependent, and would be in an institution if she hadn't been adopted - so, win-win-win with Medi-Cal saving institutional costs, adoption, and me being at home! Char
  12. I am an Independent Nurse Provider with Medi-Cal, In Home Operations, Home and Community-Based Services. I care for a Medically Fragile child in my home, and bill Medi-Cal. It's been a win-win situation for 4 years. Medi-Cal approves of my home documentation, but, there are rumblings from the State Controller's office with the thought that the 12 hour shift documentations are "not enough" to warrant 12 hour billing - and the State of California may want to be reimbursed for what they (the State Controller office) is calling "not enough" documentation to support 12 hours of care in a home. Please, anyone here who works as an Independent, or in Home Health, can you e-mail me a blank documentation form that you use? The idea that the State Controller's office can bypass Medi-Cal and go to individual nurses to demand money to be returned because they (the office ladies) don't feel there was "enough documentation" from the RN to warrent payment is a scary situation. We are Home Based, and DON'T document like the ICU. In fact, I was told, in a home visit by Medi-Cal EPSDT, that I was documenting too much and to document pertinent information, and use check marks. Again, Medi-Cal is happy with my documentation, Medi-Cal is who I bill - it's the State Controllers office who cuts the check and is looking for "fraud" in what they consider "not enough documentation to warrent paying a nurse 12 hours a shift". My fax # is 1-314-689-8160
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