NP Salary (independent practice vs. nonindependent)

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Specializes in Emergency, Occupational, Primary.
I don't think that is true anymore. NPs can bill independently but they are only reimbursed at 85% of what a physician makes even if for the same diagnosis and treatment.

That's correct. NP's can bill most insurance companies separately under their own insurance number. This includes Medicare. Expect this to be expanded under the new healthcare bill as well. Nurse practitioners have been included in the bill as a way to make up for the increased shortage of primary care physicians.

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Generally speaking, if you're a sharp, hard working person and good at talking to people, you'll do fine independently in any business that you have special knowledge of. Medicine (whatever the letters) is no different. You'll have to save up to support yourself during the first 6-12 months until you turn profitable, and this may be as quickly as a month or as long as 12 months or more depending on the setting, type of service, and how you're paid (cash, govt, insurance, etc).

But don't let the ads for NP jobs vs the ads for MD jobs fool you. They are simply averages, and if you settle for average, you'll fit right into what those say. But, you can find and make situations that will get you paid well. You just have to know a little about how much you're worth in your setting, find a setting that you're very valuable in, and negotiate accordingly. Once I started at $95K/yr and after a year and a half and some brutal negotiations, I was at $230K/yr. Most of you will say, yeah right, but it's 100% accurate and true. I left that deal (yes, sometimes I think I'm crazy for it) but now have a deal paying the same and working around 28 hours a week. I don't have as good of a benefits package as before, but also have no ER call now :o). And, I'm starting a new biz that may be worth millions... so, by all means, DON'T settle for the laughable forty bucks or so an hour unless you're setting up your negotiations later. The sky is the limit, for now... we'll see what the govt does to it.

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Specializes in ICU, ER, HH, NICU, now FNP.

Bingo NPpeeon!

Many NP's either don't have access to, or could care less about what kind of revenue they are generating for their employer. Once you do, it changes your entire outlook on what you are willing to take on. You should know every day waht you have billed out, what you have received in payments, what has posted to where, what your A/R is, what your fixed and variable expenses are and you should certainly know what your break-even point is.

Make sure that in every employment situation you enter into, you have access to that kind of information anytime you want it.

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Generally speaking, if you're a sharp, hard working person and good at talking to people, you'll do fine independently in any business that you have special knowledge of. Medicine (whatever the letters) is no different. You'll have to save up to support yourself during the first 6-12 months until you turn profitable, and this may be as quickly as a month or as long as 12 months or more depending on the setting, type of service, and how you're paid (cash, govt, insurance, etc).

But don't let the ads for NP jobs vs the ads for MD jobs fool you. They are simply averages, and if you settle for average, you'll fit right into what those say. But, you can find and make situations that will get you paid well. You just have to know a little about how much you're worth in your setting, find a setting that you're very valuable in, and negotiate accordingly. Once I started at $95K/yr and after a year and a half and some brutal negotiations, I was at $230K/yr. Most of you will say, yeah right, but it's 100% accurate and true. I left that deal (yes, sometimes I think I'm crazy for it) but now have a deal paying the same and working around 28 hours a week. I don't have as good of a benefits package as before, but also have no ER call now :o). And, I'm starting a new biz that may be worth millions... so, by all means, DON'T settle for the laughable forty bucks or so an hour unless you're setting up your negotiations later. The sky is the limit, for now... we'll see what the govt does to it.

NPpeeon,

What kind of practice do you work in? I would love to hear more about your certification (acnp, fnp, ect). Do you work in a state that allows independent NP practice?

Any info you would like to share would be appreciated!

-KJ

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Yes I too would also be interested in finding out more about NP Peeon. Bring it on! :)

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NPpeeon, do tell!

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Probably your best bet for your own practice would be mental health. Very little overhead and the ability to charge cash and have your patients balance bill their insurance company.
I understand about low overhead in Mental Health, but why can PMHNPs charge cash and have patients bill their own insurance companies whereas other NP specialties cannot? Can't FNPs do this? (Probably this question is naive, but I'm just getting into this.) Thanks.
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Generally speaking, if you're a sharp, hard working person and good at talking to people, you'll do fine independently in any business that you have special knowledge of. Medicine (whatever the letters) is no different. You'll have to save up to support yourself during the first 6-12 months until you turn profitable, and this may be as quickly as a month or as long as 12 months or more depending on the setting, type of service, and how you're paid (cash, govt, insurance, etc).

But don't let the ads for NP jobs vs the ads for MD jobs fool you. They are simply averages, and if you settle for average, you'll fit right into what those say. But, you can find and make situations that will get you paid well. You just have to know a little about how much you're worth in your setting, find a setting that you're very valuable in, and negotiate accordingly. Once I started at $95K/yr and after a year and a half and some brutal negotiations, I was at $230K/yr. Most of you will say, yeah right, but it's 100% accurate and true. I left that deal (yes, sometimes I think I'm crazy for it) but now have a deal paying the same and working around 28 hours a week. I don't have as good of a benefits package as before, but also have no ER call now :o). And, I'm starting a new biz that may be worth millions... so, by all means, DON'T settle for the laughable forty bucks or so an hour unless you're setting up your negotiations later. The sky is the limit, for now... we'll see what the govt does to it.

New biz worth millions? I'm skeptical esp. with someone who only has two posts. I wouldn't hold my breath with this person replying on his or her background, but I could be wrong.

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I understand about low overhead in Mental Health, but why can PMHNPs charge cash and have patients bill their own insurance companies whereas other NP specialties cannot? Can't FNPs do this? (Probably this question is naive, but I'm just getting into this.) Thanks.

Mental health has a few different rules. Traditionally mental health benefits were separate from medical benefits. There were also limited providers. Because of this most providers opted out of insurance plans. This allowed them to balance bill patients for their services. What most providers do is have the patient pay cash then allow the patient to bill the insurance company for reimbursement.

This is all possible due to the relative paucity of mental health providers. In the case of medical providers this would also be possible but there are relatively more providers so it would be easier to find a provider that takes insurance with less out of pocket expense.

David Carpenter, PA-C

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