Introduction
The million-dollar question...Does medicare pat for home care services?
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Coach Michele shares her experience with starting her non medical home care business. Learn what you will need to know before legalizing your homecare/ home health business entity. Your 1st coaching session with Coach Michele starts here...so if you're interested in entering the senior care industry and want to avoid purchasing a franchise business, this video is for you. If you want more information about starting a home care/ home health business visit us @ myhomecarecoach.com and if you want more tips and coaching from Coach Michele about starting, growing, and making an impact in the home care industry, become a VIP Hybrid Client and we'll assist you from start to finish. If you're still doing your research...Join the HCP Tribe membership and surround yourself with like-minded home care agency owners in Coach Michele's HCP Tribe.
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Content
Hello everyone, this is coach michelle coming to you live from the atl what's up what's up what's up.
So today's video is about how do I or can I accept medicare in my non-skilled home care agency.
So guys, let's just jump right into it.
You can't, you cannot regular.
Medicare does not pay for the services that we offer.
Now, some of you gonna say, yes, it does coach.
Yes.
It does.
Okay.
Then great.
Go ahead and accept it.
I wish you really, really, you know, well and great success because I'm not here to debate with you.
So what I am here to tell you is that regular medicare does not pay for non-skilled services.
So if you are looking to become accredited, you go right ahead and become accredited.
What I have found is that, um, many people have ventured out because there's, many people that say, yes, you can right and I'm not here to debate with them.
So, but what has what what has happened is that when you become medicare, um, when you have a non-skilled home care agency, and you go out and accept medicare, guess what they're not going to pay for it? Because when you submit that claim you're, not even going to be able to submit the claim because you're not going to be able to go through the process, because you don't have a medicaid number your medicare, number and you're, not approved that's.
One thing.
The second thing is, when you go through the medicare, accreditation process, guys, it's, not simple and it's, very inexpensive and there's.
A is really involved.
So you know, this is what I really want to say, don't, do it that's that's? What I really want to say, but I'm going to take my time and explain some stuff to you right? So one is that they're not going to pay for regular, um, non-skilled, home care services.
So, yes, you can look through the book.
And you may see, oh, it says, companion, it says, this, yeah, it could say that and it'll say some things that make you believe that it may cover it.
However, guys think about it if they're covering skills services.
And then someone that has skilled services is using a medicare, accredited agency home health agency.
Then there may be some services under that that they would be able to provide services for and it's, not what you're offering.
You know, you guys are looking to offer non-skilled services in the home on a continual basis, meaning miss jones needs service monday through friday.
Ms, jones needs service.
Monday, wednesday and friday, but ms, jones needs service more than what medicare is paying for right.
So a lot of medicare benefits are 30 days for the year.
So do you really want to go out to someone's home in this capacity that you're serving as right for one visit a week? Two visits a week for x amount of weeks is that what you want to do if so that's something totally different.
And maybe you should be looking into becoming a skilled home health care provider, right? And again, like my previous video, I mentioned, um, when I was talking about medicaid is is is is that it's specific pro programs right? So, like medicare advantage medicare advantage does have services to pay or benefits to cover the services that you offer on a non-skilled basis.
Those are still limited, however, that's, what you guys should be looking at the medicare advantage and not the traditional medicare.
And with the medicare advantage, you do not need to go to through that extensive medicare, accreditation and paying that huge dollar amount right.
So one of my clients that is that owns a home health business in, um in the states, she literally is still going through that medicare, accreditation process and she's already spent over a hundred thousand dollars and it's.
I think she recently said, she's up to a year, and she hired a company to help her with the accreditation so guys, you got to have money.
Many of you that I've had conversations with many of you that sent me information saying, I want to start my home care business.
And I don't have money, that's another video, because how can you start? And you have no money, literally, you guys are saying you have no money guys that is impossible.
It is impossible.
If you have zero dollars to start this business and any other business that I could think of with zero dollars a legitimate business with zero dollars, right? So you got to be very mindful of your expectations and your intentions.
If you have zero dollars, you shouldn't be thinking about medicare at this point, because you must have money to go through that accreditation.
You must have money in the bank.
You must have access to money and, um and we're not talking about, you know, ten thousand dollars right.
So this is a significant amount that you must have.
So I want you guys to really do your due diligence and understand wanting to accept medicare in your business is different than medicare, actually paying for your services.
So I I did a training on medicare advantage and many of my clients.
I did and many of my clients do and currently are accepting and going through the process with medicare advantage.
So if you want to accept that, I do have a candid conversation.
You can purchase the replay on my website, myhomecarecoach.com click on services and then candid conversations.
And you can see there's many there that would be beneficial.
However, the there's one specifically there, I think it was my first one.
I did a couple of months ago on medicare advantage and it'll give you the details of it.
And and what to do and how to do to be in a position to help individuals that have medicare advantage as a benefit as an insurance.
And then many of you are talking about other insurances, meaning major medical insurance companies.
Guys major medical insurance companies follow the guidelines of medicare.
So what does that mean you can have and I'm not talking about the insurance comp, uh, uh, major medical insurance companies that are affiliated with the medicare, um, excuse me, medicaid waiver programs, that's, not what I'm talking about I'm talking about going directly to a third party, major medical insurance company and saying, hey, I want to be a provider.
You may go through that credentialing process, it's not going to be expensive.
However, I promise you guys.
I promise you.
I promise you, you will start servicing that client and guess what's going to happen you're, not going to get reimbursed because you're going to be on this seesaw, remember up and down up and down up now.
And what that means is that you're going to be servicing a client through one of these long-term insurance companies major medical insurance companies that follow the guidelines of medicare, you're going to submit your claim and then they're going to say you submitted to medicare.
First, if the person has medicare submitted to medicare, first and then we'll pay, when you go to submit it to medicare, you're, not going to be able to submit it guys, please trust your coach on this you're, not have I ever steered.
You wrong.
I'm.
Just here to drop some nuggets, please I'm trying to save you some headache, some sorrow right.
So I like that that was kind of dramatic, right some sorrow, I'm trying to save you some sorrow.
So right.
So the what's gonna happen guys is that you're going to submit they're going to say you can you can't and then you're going to go back to the blue cross blue shield, or whomever and they're going to say you can't and you're going to go back and forth up and down up and down up and down you're, not gonna get paid right so trust your coach guys trust your coach.
You could do your due diligence.
So you get your own understanding because just like scripture, you can take one piece and make somebody think they're doing something wrong or doing something a different way.
But then when you read the whole scripture, you got a totally different understanding so I'm here, just to drop this insight into your your your your brain right? And then you go out and do your research and your due diligence.
And then if you find something different because things change all the time, if you find something different you like, hey, coach, some things have changed.
I am medicare credited.
And I do have a non-skilled agency, and I am getting paid and, um, you know, some things have changed I'm open right? Things.
Change evolve all the time.
However, as of today's video, no, no, no, no again, just like I mentioned in medicare, if you're offering skill services, that's, totally different, that's, that's, totally different I'm, talking about non-skilled services, specifically based on this topic.
So guys, if you found value in here, click, the bell turn on your notifications subscribe and like the video, and I would love to hear feedback from you guys and any questions that you may have.
And if I'm in a position to answer, then I will, I do respond to the questions in the comments, personally because I enjoy reading them.
So you guys take care god, bless, oh and make sure you check out, oh, I didn't tell you guys, yes, we offer financing.
We have 100 guaranteed, financing available for our coaching clients.
So if you're looking to get into our coaching program, definitely definitely send me a text to, um 678-336-7472, send me a text to 678-336-7472.
And you can also jot down in the comments that you are interested in and we'll reach out to you and let, you know what that next step looks like so y'all take care god, bless and I'll.
See you on the next video.
FAQs
Does Medicare pay for help around the house? ›
Home health care may also help to maintain your current condition or level of function, or to slow decline. Medicare pays for you to get health care services in your home if you meet certain eligibility criteria and the services are considered reasonable and necessary for the treatment of your illness or injury.
Which of the following are covered by Medicare? ›- Inpatient care in a hospital.
- Skilled nursing facility care.
- Nursing home care (inpatient care in a skilled nursing facility that's not custodial or long-term care)
- Hospice care.
- Home health care.
Home health care is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility (SNF).
What is homebound for Medicare? ›Medicare considers you homebound if: You need the help of another person or medical equipment such as crutches, a walker, or a wheelchair to leave your home, or your doctor believes that your health or illness could get worse if you leave your home.
Can someone with Medicare get IHSS? ›If you are recovering from an injury or illness that requires skilled health care assistance, you may qualify for Medicare's home health care services or IHSS in California. Being able to recuperate at home is not only cost effective, it is more convenient and comforting for you and your caregiver.
What are the 4 things Medicare doesn't cover? ›- Long-Term Care. ...
- Most dental care.
- Eye exams (for prescription glasses)
- Dentures.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
patient abuse or neglect; felony convictions or other health care related fraud; theft or other financial conduct; felony convictions related to unlawful manufacture, distribution, prescription or dispensing of controlled substances.
What 6 types of services does Medicare Part A pay for? ›Medicare Part A hospital insurance covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care.
What is an example of home health care? ›Home health care includes skilled nursing care, as well as other skilled care services, like physical and occupational therapy, speech- language therapy, and medical social services. These services are given by a variety of skilled health care professionals at home.
Which patients most frequently require home health services? ›- Alzheimer's Disease.
- Chronic kidney disease.
- Chronic obstructive pulmonary disease (COPD)
- Diabetes.
- Heart disease.
- Recovery from illness or surgery.
- Chronic conditions or injuries.
What are days of care? ›
Days of Care means the number of days in which a youth placed in, and physically present at, a facility operated by the Provider, plus the number of days of allowable absences during the time in which the youth is in placement in such program.
Which of the following is covered by Medicare Part A quizlet? ›Medicare Part A's inpatient hospital coverage is for a semi-private room and the other usual charges for necessary hospital care: meals, supplies, medical services, drugs taken as an inpatient, so on.
What are the 4 parts of Medicare quizlet? ›- MEDICARE Part A. Is hospital insurance and it covers. inpatient care at a hospital, skilled. ...
- MEDICARE Part B. Is like medical insurance. This covers. ...
- MEDICARE Part C. Is prescription and drug coverage either. through adding a Medicare prescription. ...
- MEDICARE Part D. This is prescription drug coverage with.
Part B helps cover medically-necessary services like doctors' services, outpatient care, durable medical equipment, home health services, and other medical services. Part B also covers some preventive services. If you have Part B, you pay a Part B premium each month. Most people will pay the standard premium amount.
What services are covered under Medicare quizlet? ›Covers Inpatient hospital care, skilled nursing facility care, home health care, and hospice care.