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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

 

 

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

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

lynncrni
totally agree about loosing

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

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