Forum topic

4 posts / 0 new

Fri, 09/04/2020 - 21:27

Denise Doscher

Billing Medicaid for PICC's

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

Sat, 09/05/2020 - 01:17

lynncrni

You may have identified the

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

Wed, 09/09/2020 - 06:25

(Reply to #2) #3

Denise Doscher

Thank you Lynn, I will take

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

Wed, 09/09/2020 - 13:40

(Reply to #3) #4

lynncrni

totally agree about loosing

totally agree about loosing business by holding on to your integrity. been there several times. Good luck.