self employed lpn

[jive shaman]

Hey guys just wondering if any of you guys (lpns) are self employed

Im trying to work for myself as a home health nurse and I dont want to go through an agency

Basically I just want to post ads and make flyers and business cards and have patients or patients families call me directly then I go out to their homes do my thing and bill them

is the possible or even allowed?

[Leelee2]

Quite sure that you will need an RN to provide indirect supervision in my state.

[caliotter3]

I've done private duty before. It is possible. Gets easier once you get that first case. Realize that you will be privately paid in most cases. If an insurance company is involved, most of them still rely upon agencies to provide the nurses. Try to get your employer/patient to do the tax deductions, etc., otherwise you will be liable. And it is best to draw up a written contract before you start.

[BreeLPN2RN]

This is something I would be very interested in also. I'm self motivated & have had a non-nursing online business for 12 years.

[Witty3RN]

Don't forget about the Liability Insurance.

[OttawaRPN]

Sigh.

DEFINITELY don't require RN supervision in my area, many LPNs are self employed in home care, flu clinics, health fairs and foot care.

[roser13, ASN, RN]

Don't forget about the liability insurance.

A VERY healthy liability policy.

[Up2nogood RN, RN]

I was self employed and it was a major PITA. Remember you'll have to save and pay quarterly for taxes, plus more likely extra taxes-consult a tax professional in your state (I had to pay an extra 7.5% for social security), Liability Insurance, no workmans comp to cover you, no health insurance or any benefits, and you are at the mercy of the insurance company. I had several instances where my check was held up for over a month lost in the shuffle somewhere, very frustrating. Definitely not worth it to me.

[jive shaman]

I've done private duty before. It is possible. Gets easier once you get that first case. Realize that you will be privately paid in most cases. If an insurance company is involved, most of them still rely upon agencies to provide the nurses. Try to get your employer/patient to do the tax deductions, etc., otherwise you will be liable. And it is best to draw up a written contract before you start.

Thank you for the quick reply

how did you get started doing private duty?

Is it as easy as just getting insurance, finding clientèle and going to work?

I understand the importance of having written contracts, what other paper work is involved

actually theres a ton of questions I have about starting this up I cant find any info online

I've worked for a home health agency before an example of once case I had I went to a clients home twice a day to change his wound dsg did a set of vitals, documented had him sign my time sheet then left. Dropped my documentation and time slip off at the office and picked up my check on friday.

So if I was working for myself would I just fax all documentation/progress notes to his MD and be on a one on one basis with the doctor since theres no more middle man? I assume so right?

can insurance companies refuse to pay me?

am I allowed to bill medicare/medicaid?

[OCNRN63, RN]

Hey guys just wondering if any of you guys (lpns) are self employed

Im trying to work for myself as a home health nurse and I dont want to go through an agency

Basically I just want to post ads and make flyers and business cards and have patients or patients families call me directly then I go out to their homes do my thing and bill them

is the possible or even allowed?

You'll need pay your own taxes, SS, etc. You'll need a good malpractice insurance policy. Are you going to be available 24/7? Carry a pager? You'll need to consider what your patients will need to do if they have needs on off hours if you're not going to be available 24/7. What about taking orders from physicians? What if you identify something your patient needs--does your state permit you to call a doctor and take orders directly from him/her? What if the patient has a skilled need that you are not permitted to do per your state's nurse practice act?

Lots and lots to consider.

[JustBeachyNurse, LPN]

To bill medicare or medicaid you need to be credentialed by Medicare, Medicaid is state based and again, you would need to follow the process to be credentialed. Medicaid & private health insurance credentialing is a large task, hence there are many companies who will help you get credentialed for a fee.

Medicare is barely paying physicians, so the reimbursement for an LPN would be even lower. Medicaid often pays less than Medicare. If you accept Medicare or Medicaid you must accept whatever they deem as a reasonable payment.

Private insurance companies have their own credentialing requirements. Like others said, aside from APN's most work only with agencies for home care nursing.

Here's an application to be credentialed as an individual provider with Medicare. Note only clinical nurse specialists & advance practice nurses are listed as acceptable non-physician providers.

http://www.cms.gov/cmsforms/downloads/cms855i.pdf

You may also want to check with your state's nurse practice act or BON to ensure that working as a self-employed LPN is permittable. Many states require that an LPN work under the direction of an MD/DO, DDS, or RN.

Self-employed is not the same as a independently contracted (1099) worker who staffs immunization clinics, health fairs, clinics, etc.

If you find that it is in fact doable, consider finding a good small business CPA to help you set your books & tax payments up correctly from the start. Consult an insurance professional as you may need general liability (plus specific riders for your vehicle) in addition to malpractice insurance.

[roser13, ASN, RN]

"can insurance companies refuse to pay me?"

Yes, of course they can.