We hope you all had a wonderful Independence Day earlier this week and could spend time with your loved ones. I wanted to start July with a bang and share some information for those newer agency owners and operators about five ways your Home care agency gets compensated for providing care to your clients. Please note, however, that some of these Payers will require you to go through a registration and vetting process before accepting clients from them. The five Payer types that will be covered today are:
- Private Payers
- Long-Term Care Insurance
- Medicaid
- Veterans Affairs
- Waivers/Respite Programs from Area Agency on Aging
Private Payers
Starting off with Private Payers; these are your clients paying for their care out of pocket via their savings. Typically Private Payers will also pay their invoices faster, as there is no one in the middle sending the invoice off to the billing department of a large company or organization.
Long Term Care
Next, we have Long Term Care Insurance Clients, which I’ll abbreviate as LTC. Sometimes private pay clients also have a policy with an LTC company. LTC clients are a great source of revenue for your agency. However, be aware that you must comply with the LTC company’s policy every step of the way.
For instance, with LTC clients, you must check off each task you completed for the client during their shift. LTC companies want to ensure that your agency is meeting the appropriate number of ADL and IADL tasks. This is for two main reasons; firstly, the completed tasks show that their client is receiving care. Secondly, the completed tasks show that the client needs the care provided and paid for by the LTC policy.
Medicaid
Third is Medicaid. To be eligible to take on Medicaid clients, your agency must be approved and registered with your state’s Medicaid program. Which requires you to submit the appropriate documentation and paperwork and complete training. Of note, Medicaid reimbursements vary from state to state. So while states such as Pennsylvania may have a higher Medicaid reimbursement rate, other states, such as South Carolina, might have a lower rate.
Veterans Affairs
We now move on to the Veterans Affairs programs. The VA has multiple programs that can pay for the care of veterans and eligible dependents. Some of these programs require your agency to be enrolled in a program with the VA itself. While others, such as Aid & Attendance, allow the client to pick their agency and then get reimbursed for their care needs up to a certain dollar amount.
Note also that the VA has various rules and regulations regarding how much care or assistance a veteran is entitled to, including what period the veteran served and whether they were honorably discharged.
Area Agency on Aging (AAA)
Finally, Waivers and Respite Programs from your local Area Agency on Aging (AAA). AAA, separate from the company that helps you out of sticky situations with your car, often has funds to provide respite programs in your community. You will need to sign up with your local AAA to be eligible for receiving referrals and providing care to clients who are a part of that program.
Thanks again for your time today, and we hope that this information is valuable to you and your agency. For more information on how to work efficiently and effectively with Payers and Referral Sources, don’t hesitate to get in touch with me at 678-340-3649 or twest@seniorcareba.com. Our team looks forward to working with you because we care!
