I have an in-home health care agency, how do i accept payments from clients who use long term care insurance?

Answer 1

Really easily. Just fill out the claim paperwork from the client (they'll need to get that for you to fill out before the claim is approved.) You'll need a copy of your license, plan of care, daily care notes, and all bills. Make sure the client understands that if the claim is denied, they will be responsible. Once that is received by the insurance company, have the client sign an assignment of benefits form from the insurance company and you will be paid directly the rates that you charge. If the assignment of benefits is not done, the client will receive the payment, and then you get it from them. I help my clients every day do this.

Answer 2

LTC/Home Healthcare insurers do not require any provider to be "participating" in order to be paid; these policies don't work the way regular health insurance works. However, your agency must comply with the requirements that LTC insurers typically expect -- otherwise, your client's claims will be denied. This includes licensure by the state where the service is provided and inclusion on that state's list of recognized agencies. Typically, the insurer will only issue payment if the person providing the care is an employee of the agency.

Also, not all of your clients' LTC policies will cover in-home care. On many policies, this is an option that must be purchased. If your clients didn't purchase the in-home care option, there is no coverage. I'm aware of several LTC policies that have "alternate care" options (meaning that if in-home care will prevent a nursing home admission, a benefit of some kind is payable. But this must be in the policy for an alternate benefit to be considered.)

There's another kind of policy referred to as a "Home Health Care" policy that will cover your services -- but again, only if the worker providing the care is an employee of an agency.

Payment is made directly to your clients, who, in turn, pay you.

Answer 3

Yiou would have to become a provider. Call each insurance that you would be willing to accept. You agree on rates I am sure there is some kind of proposal or bid on your part and they accept or they don't. You will have to meet guidlines I am sure like with training and licensing. This is what I would gather, but maybe ask a company in another state that you are not in competition with and they may be more forthcoming to you because you are not in competition.