Innovation in
Innovation in
Advanced
Advanced
Practice Nursing
Practice Nursing
Presented by Presented by Karen Finck, APRN, Karen Finck, APRN, CNSCNS Mental Health Counseling Services Mental Health Counseling ServicesCreating a
Creating a
Private Practice
Private Practice
You are approaching the You are approaching the world on a different level world on a different level
Your education Your education Your license Your license Your certification Your certification Give you options Give you options
When you add yourself When you add yourself
Your passion Your passion Your interests Your interests
The desire of your heart The desire of your heart
You can create... ...your work ...your future
You can be INNOVATIVE You can be INNOVATIVE Creative new solutions Creative new solutions are the future in healthcare are the future in healthcare
Right now we are in an Right now we are in an
exciting
exciting time in health caretime in health care
It is a time of Integration It is a time of Integration Mind
Mind BodyBody SpiritSpirit Holistic Health Care Holistic Health Care
Technology Technology Genetics Genetics Knowledge Knowledge
“The human brain is the most “The human brain is the most
complex thing we have complex thing we have discovered in our universe” discovered in our universe”
James Watson James Watson
Two Regions of our Brains Left Hemisphere Right Hemisphere Rational Analytical Logical Non-Linear Intuitive Holistic
Separated by the Corpus Callosum Separated by the Corpus Callosum
(300 million nerve fibers) (300 million nerve fibers)
Left brain dominated society for the past 100 years
Daniel Pink
A Whole New Mind The Conceptual Age
18
thCentury
Agricultural Age19
thCentury
Industrial Age20
thCentury
Information Age21
stCentury
Conceptual AgeIn the conceptual age In the conceptual age it will be helpful to develop it will be helpful to develop six high concept
six high concept -- high touch senseshigh touch senses
6 High Concept High Touch Senses 6 High Concept High Touch Senses
Design Story Symphony Empathy Play Meaning
They will guide our lives & They will guide our lives &
Design
Combine Function & BeautyStory
Story
Context Enriched by Emotion
Stories Teach Stories Teach
Easier to Remember than Facts Easier to Remember than Facts
Story
Story
Clients / Patients have Stories Clients / Patients have Stories
Nurses have Stories Nurses have Stories
Healing Stories Healing Stories
Symphony
Put together the pieces and see relationships in unrelated things
Big Picture Broad Patterns
Symphony
Symphony
Brainstorming Brainstorming QuantityQuantity –– Lots of IdeasLots of Ideas Encourage
Encourage wildwildwildwildwildwildwildwildideasideas Be visual
Be visual Defer Judgment Defer Judgment
Build on each other’s suggestions Build on each other’s suggestions
Empathy
Imagine yourself in someone else’s position and intuit
what they are feeling
Important Role in Healing
Play
Fun, Games, Laughter, Humor, Light Attitude, JoyfulMeaning
Spirituality
:
The basic desire to find meaning and purpose
in one’s life
Meaning
“The purpose of
“The purpose of
life is to seek
life is to seek
happiness”
happiness”
~The Dali Lama ~The Dali Lama
As Nurses, if we develop those six senses as we enter the
Conceptual Age, we will continue to evolve in both our personal and professional lives
Making the decision
"Your playing small does not serve the "Your playing small does not serve the world. There is nothing enlightened world. There is nothing enlightened about shrinking so that other people about shrinking so that other people
will feel secure around you." will feel secure around you."
~ Maryanne Williamson ~ ~ Maryanne Williamson ~
Creating a private practice Creating a private practice
Education
Education
Nursing License Nursing License ANCC Accreditation ANCC Accreditation DEA License DEA License Collaborative agreement Collaborative agreement with MD if prescribing with MD if prescribing January 1, 2015 January 1, 2015––Cost varies with specialtyCost varies with specialty
––Typical $1,000,000 Typical $1,000,000 / / $6,000,000 $6,000,000 coverage
coverage
––Average Average cost cost $700 $700 –– $2,000 $2,000 a year a year for prescribing
for prescribing
––About $400About $400--600 for psychotherapy600 for psychotherapy
Malpractice Insurance
Malpractice Insurance Employer ID Number (EIN) Employer ID Number (EIN) Tax ID NumberTax ID Number
––Can be Social Security NumberCan be Social Security Number
––Can Can apply per phone, mail, or apply per phone, mail, or online
online
––www.irs.ustreas.govwww.irs.ustreas.gov
Needed
Needed for for MNCareMNCare
––Provider Provider taxtax--2% from health care 2% from health care providers
providers
––Paid Paid on a quarterly on a quarterly basisbasis •
•Payments Payments done through the done through the InternetInternet www.taxes.state.mn.us
www.taxes.state.mn.us
State Tax ID Number
State Tax ID Number What form willWhat form will your practice take? your practice take? Work with a group? Work with a group? Collaborative private practice Collaborative private practice
Incorporation Incorporation –– LLC LLC –– PAPA Book Book Lawyer Lawyer
Legal Structure
Legal Structure
Fees FeesName of your business Name of your business
Register your name Register your name
http://www.revenue.state.mn.us/ http://www.revenue.state.mn.us/
Decide if you want to get paid by Decide if you want to get paid by Insurance Reimbursement or Insurance Reimbursement or Cash?Cash?
What services do you offer? What services do you offer?
Who are your clients? Who are your clients?
What geographical area are you in? What geographical area are you in?
Insurance Provider Insurance Provider
•
•Gives you a referral base to get Gives you a referral base to get clients
clients
•
•Listing on their websiteListing on their website
•
•Connects you with other providersConnects you with other providers
•
•Easier for clients to find youEasier for clients to find you
Cash
Cash--paying Clientspaying Clients
•
•Smaller referral baseSmaller referral base
•
•Are you willing to negotiate on fees?Are you willing to negotiate on fees?
•
•Economic climateEconomic climate
•
•Location Location will make a will make a differencedifference
Options for Payment Options for Payment
•
•Have Have client submit own form to the client submit own form to the insurance company (need a
insurance company (need a SuperbillSuperbill)) OR
OR
•
•You submit to the insurance You submit to the insurance company and collect the company and collect the restrest ((copayscopays, deductibles, etc), deductibles, etc)
““SuperbillSuperbill””
•
•Includes the followingIncludes the following
––Provider name, address, Tax ID Provider name, address, Tax ID number
number
––Service providedService provided ––Length of serviceLength of service
––Date and Location of ServiceDate and Location of Service
––Client name and insurance informationClient name and insurance information
Contact insurance companies Contact insurance companies
to become a contracted to become a contracted
provider provider An in
An in--network providernetwork provider
Credentialing to
Credentialing to Become Become an an In
In--Network ProviderNetwork Provider
•
•Takes Takes an average of an average of 33--4 4 months to get months to get status as a provider
status as a provider •
•If already If already credentialed credentialed through an through an organization, it
organization, it may be may be easier to get easier to get extended into a private practice extended into a private practice situation
situation
Credentialing Credentialing
•
•Go to MN Credentialing CollaborativeGo to MN Credentialing Collaborative •
•Complete application process onlineComplete application process online •
•Complete specific information for the Complete specific information for the insurance company insurance company CAQH CAQH National Credentialing National Credentialing •
•Some insurance companies through this Some insurance companies through this website
website
Credentialing Credentialing
•
•RecredentialingRecredentialing every 2every 2--3 years3 years •
•Insurance companies initiate Insurance companies initiate recredentialing
Separate Application Minnesota Separate Application Minnesota
Health Care Programs (MHCP) Health Care Programs (MHCP)
Medical Assistance Medical Assistance MN Care MN Care Separate Application Separate Application Medicare Medicare PECOS PECOS Billing Billing
All billing for health care All billing for health care must be electronic in the state must be electronic in the state
of Minnesota of Minnesota Health Records Health Records Documentation System Documentation System EHR EHR Practice Management Practice Management Billing Billing Scheduling Scheduling Collections Collections Will you do it? Will you do it? Will you use a Will you use a collection agency? collection agency? Marketing Yourself Marketing Yourself Referral network Referral network Word of mouth Word of mouth Website Website Get Domain Get Domain GoDaddy.com GoDaddy.com Brochures Brochures Business Cards Business Cards
Tell your story Tell your story Create your milieu Create your milieu
Office Space Office Space Warm and inviting? Warm and inviting? Clean and Clinical? Clean and Clinical?
Reception Area Reception Area Coffee Coffee Water Water Tea Tea Privacy Privacy Sound Sound Music Music
HIPAA
HIPAA
Policies and Procedures Policies and Procedures
Forms Forms Training Training
Business Associate Agreements Business Associate Agreements
Communications with Communications with Clients HIPAA Compliant Clients HIPAA Compliant
Email Email Text Text Cell Phone Cell Phone EHR Portal EHR Portal Receptionist or Receptionist or Receptionist Sign Receptionist Sign Please come in, sit down, Please come in, sit down, Please come in, sit down, Please come in, sit down, Please come in, sit down, Please come in, sit down, Please come in, sit down, Please come in, sit down,
help yourself to coffee. help yourself to coffee. help yourself to coffee. help yourself to coffee. help yourself to coffee. help yourself to coffee. help yourself to coffee. help yourself to coffee. The therapist will be The therapist will be The therapist will be The therapist will be The therapist will be The therapist will be The therapist will be The therapist will be
with you shortly. with you shortly. with you shortly. with you shortly. with you shortly. with you shortly. with you shortly. with you shortly.
Reimbursement Reimbursement Group 60 / 40% Group 60 / 40% Income Income $83,200 $83,200 $104,000 $104,000 $124,800 $124,800 $200,000 $200,000
Private Practice Benefits Private Practice Benefits
Flexible Scheduling Flexible Scheduling Set your own hours Set your own hours
Vacations at will Vacations at will Control your practice Control your practice See the clients you want See the clients you want
Private Practice Private Practice Financial Analysis Financial Analysis No Workers Compensation No Workers Compensation (can buy your own policy) (can buy your own policy)
No unemployment No unemployment
7.5% more tax 7.5% more tax
Purchase your own health insurance Purchase your own health insurance
Who will do lab work? Who will do lab work?
Collaboration
Collaboration
Who will do genetic testing? Who will do genetic testing? Who will fill prescriptions? Who will fill prescriptions?
Who will you refer to? Who will you refer to?
Coverage Coverage Don’t get isolated Don’t get isolated
Consultation Consultation Education Education Support System Support System
Establishing a Private Practice requires time and energy It is a journey worth taking It is a journey worth taking
Contact Us . . .
Mental Health Counseling Services 615 First Avenue NE, Suite 310 Minneapolis, MN 55413 Tel: 612-436-0295 Fax: 612-436-0163
www.healthcounselingservices.com hcs@healthcounselingservices.com
