How to Become a Medicare Certified Home Health Agency

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Home health care agencies employ nurses, certified nursing assistants (CNAs) and home health aides, who take care of the elderly in their homes. If you are compassionate, hardworking and have business sense, opening a home health care agency will not be difficult. Before you open your agency, make sure you obtain Medicare certification. Not only will this give you clients peace of mind, but allow you to bill Medicare for your services.

Check with your state's department of health. The federal Medicare system has its own enrollment guidelines, but it allows states to set additional guidelines.

Medicare serves people 65 or older, people under age 65 with certain disabilities, and people of all ages with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant), according to the U.S. Department of Health and Human Services.

Fill out the Provider/Supplier Enrollment Application and send it to your state's Medicare administrative contractor. Submit all necessary documentation with your application. Owners of home health care agencies must pass a criminal background check, have a billing address and a business license.

Obtain a National Provider Identifier (NPI). Without this number, you can't bill Medicare. You can apply online at the National Plan and Provider Enumeration website or call 1-800-465-3203 for an application.

Hire nurses, CNAs and home health care aides who are certified and have passed a criminal background check. Medicare will not pay for services rendered by an employee who isn't certified.

Tips & Warnings

  • Many Medicare enrollment applications are denied, because providers fill out the wrong forms. Complete the CMS-855A form available in the resources section.

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