Transition to 1099/independent contractor

[Erica Patterson]

Hi everyone,

I'm a Texas-based RN currently working in pediatric home health with 5+ years in the field. I care for a medically fragile child under the STAR Kids Medicaid program and am strongly considering transitioning into independent practice to cut out the agency and retain full reimbursement for my work.

 

I already have:

    •    An active Texas RN license

    •    NPI number

    •    Professional Liability Insurance

    •    Experience using CubHub (I plan to continue using this independently)

    •    A decent understanding of Medicaid CPT codes (e.g., S9123) and the current reimbursement rates for private duty nursing

Right now I'm in the middle of:

    •    Completing enrollment through TMHP as an independent provider

    •    Planning to credential with the patient's MCO (STAR Kids — BCBS)

    •    Figuring out how to coordinate the transition without any gap in services

    •    Weighing the need for things like a Direct Secure Messaging endpoint or setting up HIPAA-compliant communication without a formal EHR

 

I'd love to hear from others who've gone independent:

    •    What did your transition process look like?

    •    How did you handle the overlap with the agency or coordinate authorization transfers?

    •    Are you billing Medicaid yourself or using a billing service?

    •    Any advice on credentialing with private insurance or managing secure documentation?

    •    Lessons learned or things you'd do differently?

This is something I've been researching and planning carefully, but hearing from others who've walked this path would mean a lot.

 

Thank you so much!

 

— Erica

[urbanvaughn15]

Making the move to independent practice looks like a big step, and the way you laid out your preparation shows how much thought went into it. I understand the appeal of managing your own authorizations and billing, especially in home health. I'd focus on keeping communication clear with the MCO during the transition, because smooth coordination usually prevents gaps in care and helps the first claims process without issues.