I have read many things regarding this topic, but I am still confused. I own a Vascular Access company and have had many skilled nursing facilities ask if I can bill Medicaid for PICC and Midline placement at the facility. There is a competitor company who tells these DON's that they can bill Medicaid, I am not sure how they are legally able to do this. My understanding is that only a NP/PA or MD who places the line can bill for it. Also, I understand that Medicaid reimbursement is really low, sounds like it would not cover the cost of the kit/supplies and the nurse charge for placing it. Anyone know where I can verify this information or do you know if Medicaid can be billed? I cover skilled nursing facilites, acute rehab hospitals, infusion centers etc.
Thank you so much for any information,
Denise Doscher, RN, VA-BC,CRNI
You may have identified the key word in what your competitors are doing - "legal". They may be billing Medicare under an agreement with a provider, but this is fraud! I hope they are not doing this but t he only professionals that can directly bill Medicare is MD, NP, and PA. Almost every paitent in a SNF will be dual-eligible - both Medicare and Medicaid. To my knowledge you will be much safer billing the SNF and having them bill the provider. But if it were my business, I would pay an attorney with healthcare billing and Medicare experience to provide advise on your questions.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thank you Lynn, I will take your advice on that particular type of attorney. It is hard to compete with people whom lack integrity, weird thing to say but it has been an eye-opening experience for me. Running a business with integrity makes you lose business at times. But I will always do the right thing. Thanks again.
Denise Doscher RN, VA-BC, CRNI
PICCsmart
[email protected]
800-324-2835
totally agree about loosing business by holding on to your integrity. been there several times. Good luck.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861