I am a home health care provider residing in the state of Florida. I
do care giving for elderly, physically disabled and mentally
challenged individuals. I work as an independant contractor (home
health aid) for a nurses registry. I would like to quit working for
the agency because they are taking too much money out of my pay.  I
would like to take on my own clients and work directly for my own
clients.  Several of my clients have long-term care policies which the
agency bills for sevices that I perform (ADL's).  When I quit the
agency and take on my own clients then how would I, as I private
individual go about billing the long term care insurance for sevices
that I perform?  I know one does not need to be an agency to do this
because I also am an independant medicaid waiver provider.  I have a
billing number to bill medicaid eligable clients and can do that
without the agency.  Now I need to know how to bill the long term care
insurance policies also. Please be as specific as possible.  Thank you
very much.

I work for an insurance company in the Long Term Care department.
Unfortunately in this situation there is not much you can do. While
the government will accept your medicare waiver number, insurance
companies tend to be a bit more stingy. They are currently accepting
the registry because it is considered a licensed provider within the
state of Florida. The only state that an individual can be considered
for payment under LTC benefits is California. There are some other
options though. Many who have LTC benefits have riders that will allow
anyone, family members or otherwise to provide the care. If someone
has this rider attached to their policy the insurance company would
still be required to pay. Most insurance companies only require one
hour of service from a licensed provider to pay benefits for a day--if
you could find someone who recieves that one hour and needs more care
at a lower cost that could also be a workable situation. Unfortunately
there are not a lot of options in this situation. If I were you I'd
look into how many need to be on staff and what the requirements are
to become a licensed provider. I hope this has been helpful and I wish
you the best of luck.

Thank you very much for taking the time to give me this info.  I
appreciate it and I will look into it further.