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, 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.