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Medicaid Nurse – How to Enroll

Did you know that you can work as a private nurse and bill the state for your services? Every state has a Medicaid nurse program that allows you to enroll as an independent nurse provider. By acquiring your Medicaid provider number, you can begin a career as an independent nurse.

Medicaid Nurse programs vary by state. It is important to look up the qualification criteria for the state that you live in. For this blog post, we will be using New York as an example. To begin your enrollment, you must go to the eMedNY website. The application to enroll is free, but it often takes several weeks to process.

Step 1 – NPI Number

Every Medicaid nurse provider must have a National Provider Identification number. This number generated immediately through the NPI enrollment website.

Step 2 – Medicaid Enrollment Application

Next, you must submit your Medicaid nurse enrollment Application. You can enroll as an LPN or as an RN. Keep in mind, this application pertains to the individual nurse provider. Therefore, do not use any patient health information. This application will be reviewed by the New York State department of health. You must submit a notarized Certification Statement and an Electronic-Funds Transfer Authorization for direct deposit with your application.

Step 3 – Provider Manuals

It is important to familiarize yourself with the guidelines that apply to your provider class. Provider manuals are free to download from the eMedNY website. We recommend that you also sign-up for the monthly Medicaid update newsletter.

Step 4 – Client Eligibility Verification

Every nurse provider must verify their client’s eligibility prior to providing care. There are multiple ways to verify client eligibility. Using your client’s prior authorization number and the Medicaid Eligibility Verification System (MEVS) system is the easiest method. Authorizations must be renewed over time. So, you must submit your next authorization request prior to the expiration of the current authorization.

Step 5 – Claim Submission

Nurse providers have several options to submit claims. The Electronic Provider Assisted Claim Entry System (EPACES) is the easiest method. EPACES is a free software provided by the Medicaid system. All claims must be in HIPPA compliant format. Reimbursement rates vary depending on provider class and county.

Are you ready to start working as a private Medicaid nurse? NurSearch can help you find your first clients! Sign-up today!


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