Private Duty Nursing

Allegheny County,

Pennsylvania Team

At BAYADA, we are committed to easing the process of determining eligibility and starting services, including navigating insurances and other benefits.

There are four considerations in confirming your eligibility for in-home nursing services:

Referral:
Your doctor must make a referral confirming the necessity for complex clinical care that cannot be safely managed by untrained caregivers alone.

Location:
We must ensure that you reside within a geographic area that BAYADA serves.

Insurance:
We will check your insurance coverage to ensure payer authorization and approvals (Medicaid, Medicare, private coverage, or programs that fund private duty nursing).

Assessment:
Our clinical team will conduct an initial assessment to ensure that your medical, developmental, and safety needs are within the scope of services BAYADA provides.

BAYADA smooths the process of getting nursing care for you or your loved one.

First step:
connect with your health care provider. Ask your doctor for a referral for private duty nursing services at home. Contact your local BAYADA office or email [email protected]. A friendly intake coordinator will walk you through next steps, answer questions, and gather information about your needs.

Complete intake and insurance authorization. BAYADA works side-by-side with families to handle insurance approvals and paperwork, aiming to ease worries and speed up start of care.

Once services are approved, a BAYADA nurse manager assesses your needs, goals, and home situation to create a nursing care plan and schedule. A dedicated nurse manager will assemble and onboard a care team, matching experienced nurses to your unique needs and preferences.

Service begins—with ongoing support. Nursing shifts are scheduled for reliability and continuity by a dedicated client services manager. Your nurse manager will remain in contact, adjusting care plans as needed.

We accept and work with a large group of health insurance companies and other payors including:

Private and commercial insurance plans Many families use their private health insurance or employer-sponsored coverage to pay for private duty nursing services.

Medicaid and state-funded programs Medicaid is a primary payment source for people requiring home nursing.

Medicare Clients enrolled in Medicare (often those age 65+ or persons with disabilities) may have portions of their nursing care paid through traditional Medicare or managed Medicare plans.

Managed Care Organizations (MCOs) BAYADA secures authorization through the appropriate MCO and follows the plan’s billing guidelines.

Other public assistance or special funding Some families qualify for additional funding through state and local health programs, special needs grants, or non-profit partnerships.

Self-pay or private pay Some families may elect to pay privately for services if they do not meet insurance or program eligibility.