This is my first post. I am about to graduate as an adult NP and I am working with Chicago Radiologists to create a new position wherein I place permacaths, PICCs, portacaths, and do thoracenteses, etc. The holdup is that ISMIE is not giving us clear answers about malpractice, as well as some role development questions regarding billing and who the employer should be (hospital vs. radiology group vs. hybrid). I need to find an NP in Illinois doing these things so that the Radiology group can get in contact with someone to ask a few questions about the role development. Anyone out there?
I would greatly appreciate any info, and I promise it wouldn't take much time.
Feb 14, '13
I work in a large nephrology practice near Peoria and none of the mid-levels (PAs, NPs) place permcaths in our practice. As to PICC lines, the RNs do them in the hospital with sonosite assistance. Central lines, IJs are done by mid-levels in the hospitals under the supervision of the intensivist. They have to do so many supervised, it has to be in their credentialling/privileging sheet and then they have to do so many per year in order to prove competency. Those folks are actual hospital employees.
Feb 14, '13
I've done chest tubes and central lines but live in Texas.
Different boards. Maybe different scopes of practice?
I can tell you that I kept a running procedure log for future credentialing process. Those done with my supervising MD present were highlighted. Keep any completed CME's directly related to the procedures you perform or workshops you attend.
There are 2 forms of billing for procedures.
1. The technical fee.
2. The professional fee.
Who is your direct employer?
If the hospital, then the hospital should bill for both.
If the radiology group is private, then the radiology group should bill for the professional fee and the hospital the technical.
Feb 14, '13
You don't have to be supervised each time you do an invasive procedure. The facility should establish a protocol that the first 5 or first 10 are supervised by an attending physician. The successive procedures can be done on your own once you have proven competence. Our facility requires that we maintain a certain number of cases for each procedure we do each credentialing period. Procedures not done frequently are either taken away voluntarily or have to be supervised by an attending.
Feb 15, '13
I know the regulatory requirements in Illinois very well considering the research I have done. Getting credentialed at the hospital is not an issue. The radiology group is trying to figure out what works best for them regarding who the employer should be, optimizing their billing if I were in a hybrid employ, etc. My objective right now is to find someone in Illinois doing procedures like joint aspirations in addition to the ones above. I know they exist, because I have seen old job postings looking for exactly that. However, the contact info on the old posting is removed since they are expired. Once I can contact someone, or at least get a name and a facility doing it, we can take that info back to the insurers to get a quote modeled after that person's practice and determine how to proceed with employment.
Feb 17, '13
You might look to Great Plains Orthopedics or Midwest Orthopedics in Peoria, IL. I know a couple of PAs there that do joint aspirates as some of my pts have had them done by PAs.
Feb 17, '13
Oh and another resource would be the IL Society of Advanced Practice Nurses ISAPN.org
Must Read Topics