[ANPFNPGNP]

Are there any NP's out there who own their practice? I plan on opening a clinic in a rural area, which has a large Medicare/Medicaid population. This town is in dire need of an urgent care clinic and I would like to fill that void. Has anyone out there attempted this type of thing? If so, do you have any pearls you can share?

[BarbaraNP]

I have been in my own practice for about 2 years here in WA State. There are lots of NPs either with practice, or currently in startup phase. A friend of mine opened a walk-in/urgent care practice, in another part of the state that is doing well.

If you have specific questions, please ask, or feel free to send a PM.

Best wishes!

BarbaraNP

[ANPFNPGNP]

Originally Posted by BarbaraNP

I have been in my own practice for about 2 years here in WA State. There are lots of NPs either with practice, or currently in startup phase. A friend of mine opened a walk-in/urgent care practice, in another part of the state that is doing well.

If you have specific questions, please ask, or feel free to send a PM.

Best wishes!

BarbaraNP

Do you have to have a collaborating physician in WA? In Texas we do, but this may change in rural areas - that's currently in legislation. When the law changes, I'm hoping to open an urgent care clinic in a rural town.

Did you hire someone to do your billing? I heard that we can bill for Medicare and Medicaid online, is this true? I've looked into those EMR systems with combo billing options, but that seems really expensive. The main thing I'm worried about is the billing issue. I won't need to get on any insurance policies and I've already got a Medicare and Medicaid number.

[lananp]

[quote=ANPFNPGNP;2923159]Do you have to have a collaborating physician in WA? In Texas we do, but this may change in rural areas - that's currently in legislation. When the law changes, I'm hoping to open an urgent care clinic in a rural town.

If I'm not mistaken, NP work under MD's supervision in Texas, not in collaboration. I had some thoughts about moving to Austin after graduation(NPs work collaboratively with MDs), but I gave up that option because of that issue. For me independence and being able to open your own practice are very important.

[ANPFNPGNP]

[quote=lananp;2923460]

Originally Posted by ANPFNPGNP

Do you have to have a collaborating physician in WA? In Texas we do, but this may change in rural areas - that's currently in legislation. When the law changes, I'm hoping to open an urgent care clinic in a rural town.

If I'm not mistaken, NP work under MD's supervision in Texas, not in collaboration. I had some thoughts about moving to Austin after graduation(NPs work collaboratively with MDs), but I gave up that option because of that issue. For me independence and being able to open your own practice are very important.

I know 2 NP's in South Texas who own their own practice, but they have to pay a physician to "supervise" them. They pay them $1,000 per month to stop by every 10 days and sign off on some charts...pretty good pay for a couple of hours of work. Our BON states that we work "independently" and "in collaboration" with physicians. There is NO difference between collaboration and supervision!

Austin is saturated with NP's, because everyone wants to live there and they are paid very poorly there. I'm really hoping we get independence in rural areas, b/c that's a start. Does anyone know of a state where NP's work independently in underserved areas, but not in urban areas?

[BarbaraNP]

Did you hire someone to do your billing? I heard that we can bill for Medicare and Medicaid online, is this true? I've looked into those EMR systems with combo billing options, but that seems really expensive. The main thing I'm worried about is the billing issue. I won't need to get on any insurance policies and I've already got a Medicare and Medicaid number.

1. In WA we are independent.
2. I had hired a company, and quickly brought it in house. We had major problems with the company hired.
3. A cost effective EMR for the small office is Amazing Charts.
4. We use Office Ally and their free practice management software to bill all our claims online. Office Ally also has it's own EMR system so the whole thing is intergrated. I think the EMR is about $30.00/mo.
5. I do some work with NP business owners. This coming Sunday, I am interviewing a certified medical biller who does billing for NP practices. Anyone can listen in. Billing issues are huge for all practices.
6. Seems to me there are NPs in TX who do own their practices. I am not familiar with the practice act there.

BarbaraNP

[ANPFNPGNP]

Originally Posted by BarbaraNP

1. In WA we are independent.
2. I had hired a company, and quickly brought it in house. We had major problems with the company hired.
3. A cost effective EMR for the small office is Amazing Charts.
4. We use Office Ally and their free practice management software to bill all our claims online. Office Ally also has it's own EMR system so the whole thing is intergrated. I think the EMR is about $30.00/mo.
5. I do some work with NP business owners. This coming Sunday, I am interviewing a certified medical biller who does billing for NP practices. Anyone can listen in. Billing issues are huge for all practices.
6. Seems to me there are NPs in TX who do own their practices. I am not familiar with the practice act there.

BarbaraNP

I really, really appreciate your help.

The NP's I know pay a doctor to be their "Medical Director." Hopefully, this will be abolished within the year, at least in rural areas. If not, I've got a doctor who's willing to serve as my MD. I've only been out of school for 3 years and the first year I only worked in pain management, which was a huge mistake. I've worked in urgent care (which I love)for 2 years and I've also been working with 2 doctors in primary care 4 days per week for 10 month (they're great). I'm just trying to soak up as much knowledge
as I can before I get out there on my own.

Ironically, the doctors I work for in primary care got a NP run clinic shut down in one of the big grocery stores. One of the hospitals in town opened it and hired NP's to work there. My bosses got a petition and had over 100 doctors sign it, basically stating that they would not admit patients to those hospitals unless they closed the clinic, which they did b/c they had no choice. These docs actually said they were worried b/c the patients would get substandard care, but later one of them admitted to me that all the primary care docs were afraid of the competition b/c they couldn't compete with the prices.

I spoke to a lawyer friend of mine about this and he said that he would have loved to have taken this case. He said that he could have sued on behalf of a patient who no longer had access to medical care, since the clinic was shut down. I would have given my eye teeth to have seen this happen. I'm really tired of doctors thinking they have the "patent" on health care. I'm not saying that I can provide 100% of the care that a doctor can, but I can certainly provide 90% of it. I know when I'm over my head and need to refer.

[Tammy79, RN]

Originally Posted by BarbaraNP

1. In WA we are independent.
2. I had hired a company, and quickly brought it in house. We had major problems with the company hired.
3. A cost effective EMR for the small office is Amazing Charts.
4. We use Office Ally and their free practice management software to bill all our claims online. Office Ally also has it's own EMR system so the whole thing is intergrated. I think the EMR is about $30.00/mo.
5. I do some work with NP business owners. This coming Sunday, I am interviewing a certified medical biller who does billing for NP practices. Anyone can listen in. Billing issues are huge for all practices.
6. Seems to me there are NPs in TX who do own their practices. I am not familiar with the practice act there.

BarbaraNP

Wow. Great info. Do you have desk tops in each exam room? Also, just curious about start up costs and time it took to actually get out of debt from start up and overhead.

Thanks.