10/15/2014. You can create...your work...your future

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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 Services

Creating 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

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“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

th

Century

Agricultural Age

19

th

Century

Industrial Age

20

th

Century

Information Age

21

st

Century

Conceptual Age

In 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 &

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Design

Combine Function & Beauty

Story

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 Quantity

Quantity –– 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

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Play

Fun, Games, Laughter, Humor, Light Attitude, Joyful

Meaning

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 ~

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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

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Incorporation Incorporation –– LLC LLC –– PAPA Book Book Lawyer Lawyer

Legal Structure

Legal Structure

Fees Fees

Name 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)

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““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

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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

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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

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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

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