Do I Qualify for Private Duty Nursing Services?
Private duty nursing services are available to any person who requires skilled nursing care, when these services are ordered by a physician.
The primary barrier encountered by those who require services, is often cost. The requirements for third party reimbursement differ depending on the source. Some private insurance companies cover the cost of private duty nursing. Many patients also qualify for a number of state and federally funded programs.
Medicaid is available for private duty nursing, when the patient requires at least 8 hours a day of skilled nursing. Each request for authorization is reviewed by the Bureau of Health and Family Services and a determination is made based on the Bureau's criteria for eligibility. Although many people qualify for Medicaid on the basis of disability or income, there are other programs, such as the Katie Beckett program that make one eligible for Medicaid.
After Medicaid is granted, the patient must also meet the requirements for skilled nursing. A request for prior authorization is sent to the state, on the patient's behalf, by the PAL (Prior Authorization Liaison). It may take as long as 6 weeks for a reply. In some circumstances, services can begin before prior authorization is approved.
What if I Already have Nursing Services from a Home Care Agency but Need Additional Care?
Yes, case sharing is possible if your agency agrees. Please contact PHP for more information.
PHP will assist families in finding independent nurses through our job board and networking, but we are not an employment agency. We do not endorse the providers to whom patients are referred. Applicants are screened, interviewed and hired by the patient or family of the patient. An RN referred to as the PAL and/or "case coordinator" performs an initial assessment, develops a plan of care based on the doctor's orders, submits requests for prior authorization as indicated.
To have an ad placed on the job board
Open BOTH documents below, print and fill out completely, then submit to PHP following the instructions provided on the PHP Ad Form.
For any questions or concerns, please contact WisconsinPHP@Gmail.com.