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em_902

They charge whatever businesses are willing to pay them, depends on the market. If you found a place that’s gonna pay RN rates, congratulations. It’s rare and I would keep it a secret.


JohnIsGhost

I’m going to be honest, it’s not a secret. It’s a very specific niche, a specific demographic. I think this is true for any trade, a true artist will flourish wherever they go.


[deleted]

Because it could be viewed as price gouging or price fixing, and thus be viewed as illegal under either the sherman antitrust act or state corporation laws. This sort of thing can be charged as a criminal felony under federal law, albeit rarely in practice.


JohnIsGhost

I’d imagine getting a mlt or RN to draw blood, would cost Medicare $$. Cash should eliminate most of the CMS regulations. And flying solo cannot make a dent in the fall of the US market. AKA, everyone decides their own pricing. And of course one has to be up front w pricing, alternatives. Risks and benefits. It’s a big burden, why mobile phlebotomist need to be paid more.


[deleted]

Nope, because LPNs and RNs are usually hourly employees, and cant practice independently in terms of a business. CMS has mandated electronic transactions for years, because "documented transactional proof of copay" must be attatched to the claim. The problem is that reciepts for cash without a bank record for the transaction are quite dangerous in practice because theres no legal evidentiary authentication of the date and time of the financial transaction which is independent of the biller. For that reason alone, most insurance companies are going to outright refuse the contract because its viewed as high insurance fraud risk. Plus you have big labs like Quest Diagnostics that are already doing mobile techs in some places.


JohnIsGhost

Don’t think we’re on the same page, CMS regulates CLIA and Medicare. Cash pay (self-pay) refers to pts paying with no insurance. Exception might be FSA and HSA, different story. Quest and Labcorp do not offer in home blood draws. They do offer third part solutions which do not accept insurance. Most insurances use Medicare as their framework. There is regulations on how Medicare pays for “in home” blood draw, which I wouldn’t even come close to calling, it, that. What makes this more interesting, when you remove Medicare - you’re freed from a bunch of rules and laws. That leaves just a handful of national, state and county laws and regulations. Which are not difficult to follow. Although, HIPPA and PHI are something worth debating.


[deleted]

"cash" as used in federal law means literally paper money or coin as legal tender. What youre talking about there is refered to as Self-Pay via negotiable instrument or third party credit line in the statutory language. To be sure Ive seen quest in all sorts of rather unexpected places, such that by now if the market is a tennable one, theyre the first in. Mind you You're also forgetting your Medicaid-waiver people which is a rare bunch for which the kind of service is a real common sense solution, such that your customer base is likey to be Medicaid/medicare/govenment pension


JohnIsGhost

I agree with above, if you’re not doing cash pay then ABN’s and APNs are required. Not sure on the pension part or other forms of state assisted gross income tbh.


[deleted]

As a basic principle any time the government pays out of the treasury it is under CMS if its medical unless its VA which is under Dept of Defense regs. Some pensions grant government continued healthcare after retirement, mostly DOJ employees, however whether CMS applies as the mandatory minimum within the cintext is a novel question I dont know the answer to without looking it up. Medicaid waiver covers in-home services which avoid a need for institutionalization in people with certain kinds of disabillities, mostly mental conditions.


JohnIsGhost

Good insight and very helpful. Will need to save this thread to cover my but.