- Long term care insurance
- Worker’s compensation
- Self pay
- Select commercial carriers
All TennCare MCO’s including and Americhoice (known as United Health Care Community Plan) and Volunteer State Health Plan (known as TennCare Select and BlueCare), pay for Private Duty Services. Some Private Insurance Policies such as BCBS & Aetna will authorize Private Duty. In addition, Worker’s Compensation Companies may pay for private duty services.
MEDICARE does not pay for any Private Duty Services at this time.
TennCare and most other Insurance Companies require a Letter of Medical Necessity (LMN), from the ordering physician for Private Duty services to be authorized. This letter must include:
- the patient’s diagnosis and medical history
- an explanation of why the services are needed
- an explanation of why the caregiver cannot perform the care
- the discipline and frequency of the services desired.
Once the signed LMN is received, it is submitted, along with any other pertinent information related to the patient’s needs, to TennCare or other insurance company for review and authorization. The authorization of services can take up to 2 weeks, occasionally longer.
Please contact our office at 901.388.7773 for assistance with any part of this process.