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How to Refer a Patient to Private Duty Nursing

Working with Private Duty Nursing patients since 1995, we find that many families lack are uninformed which services their children or parents are eligible for, or the knowledge how to obtain the services. Further, many patients lack to awareness that an agency should truly provide a family framework with the personal touch and caring. This article is to bring clarity as to those who are eligible for the services, what the process entails, and how you can bring the best care to those you love.

What is Private Duty Nursing?

Private Duty Nursing is nursing care provided for critical patients in the home setting by either a Licensed Practical Nurse or a Registered Nurse.

To be Eligible for Private Duty Nursing

Insurance Coverage

Most Medicaid insurances will cover private duty nursing, though each of them may have a unique process how to get authorized. Some private insurances will cover it in full or partially but just as many may not, which is an important benefit to consider when deciding on a specific health plan for a patient.  Medicare will not cover Private Duty Nursing.

Equipment

For insurances to approve the services a patient will need to have one of the following:

  • NG-Tube
  • GJ-Tube
  • Gastrostomy Tube
  • Tracheostomy Dependent
  • Ventilator Dependent
  • Seizures*

*Patients with seizures stand a smaller chance of being approved depending on the insurance coverage and the intensity of the seizures.

The Process

Step 1: Reach out to White Glove Community Care

We have encountered many families who have this misconception that they must go through the hassle of the authorization/approval process themselves, and only once they have the approval of service do they reach out to us. We get pained when we hear how patients try to navigate this difficult process without anyone at their side. First things first, reach out to White Glove Community Care to refer your loved ones and we will guide you through with full scope support throughout.

Step 2: A devoted intake coordinator is assigned

Once you contact White Glove Community Care, a devoted intake coordinator will be assigned. From gathering paperwork, following with the insurance, keeping you updated all along, and ensuring everything is running smoothly, it is their sole goal to get you the services in the shortest turnaround time.

Step 3: Gathering Paperwork

Getting a hold of all the necessary paperwork can sometimes be difficult when that may entail and not limited to reaching out to busy doctor’s offices for a letter of medical necessity, setting up a home assessment with the insurance, or obtaining a school letter from the Board of Education nurse for a child attending school. But guess what? The White Glove Intake Coordinator does it all for you, sparing you the time and headache, allowing you to focus on your loved ones.

*Should services be denied

We do not even like to go there because mostly the process is a smooth one. Yet should any hurdles get in the way we are here to help you fight for the services in the event of an unexpected denial. We connect you with the legal support and resources you need to get to the desired outcome.

Step 4: Scheduling a Devoted Caregiver

Once the services are approved, we are in it to connect you to a team of dedicated caregivers who will give you the feeling of being surrounded by new caring family members. We understand the sensitivities of homecare, and we are here to listen to the preferences or concerns on your mind to ensure you are perfectly comfortable with the homecare setup.

The Outcome: Quality of Life 

White Glove caregivers promote health and wellness in an unreal way, both with their skill and by being so attentive. They have a huge footprint in bringing true quality of life to the patients and families they work with.

Your loved ones deserve the difference.  Refer a patient today.

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