JEKA

Thanks for the replies. There was an ad for a pain management NP out pt. no weekends or holidays! wasn't sure what it entailed

Hi, I am just wondering if there are any pain management NPs out there. If so, what is your role? thanks

Are nurse practitioners allowed to see medical assistant patients in the hospital? My billing people are saying that we will not get paid for a NP visit in the hospital, only if seen in the office. They say that medical assistance requires a doctor to see the inpt. This doesn't sound right to me. Can anyone shed some light on this for me. I am in Pennsylvania (not sure if that makes a difference). Thanks

WOW, you guys are fantastic and this site is awesome. Thank you all so much

I cover for a busy clinic practice every 5th weekend or so. This is part of my "on call" schedule with my employer. Anyway, I have been sent to the ER to evaluate pts and have gotten calls re: patients in the ER. I have given admitting orders for many, many patients. My billing person now thinks that NPs cannot not admit to the hospital and asked the medical credentialling person if I have admiting credentials. She was told that I do not. My boss seems to think the billing specialist is mistaken. I am unsure if this is a hospital policy or a CMS rule. My question is simply, Can an NP admit a patient to the hospital or would he/she have to write the order as a "verbal" order from the dr? Thanks

I am curious to know how many NPs have their DEA license. I was planning on applying for one but decided against it when I found out it would cost over 500 dollars. Any advice? Thanks. Oh, I work in cardiology ( I see both hospital inpatient as well as office). T

I am curious to know of any good resources for pharm. Now that I am "practicing" I am wondering if there are any pocket type "bullets" for prescribing. Stuff like if pt has this and is allergic to that give this or PO equivilants (conversions) for IV antibiotics etc. For ex. is Levaquin 750 mg IV the "same" as Levaquin 750 mg PO. I don't remember any thing like this in class. Maybe I need to go back to my notes. Thanks.

"however, medicare requires that the doctor see new patients and they will only let the midlevel bill at 100% if the midlevel is treating the patient for an illness/disease for which the patient has already seen the doctor." i'm confused. what about nps that have their own practice, or when we see patients in the hospital for consults and/or h&ps? "if the phyisician sees the patient and preforms all the elements of the visit he can bill for the visit. if you follow for the problems that the physician has specifically indicated a plan for you can bill at 100% under incident to. otherwise you can bill at 85% of the physician fee." so, if i see cardiology patients for follow-up and nothing cardiac wise developed, i can bill for 100% under the dr.'s # as incident to? even if he isn't in office? what about when i see new patients and the physician is in the next room? do i bill under my number for 85% or his for 100% "it depends on the insurance and most will reimburse at 100% if the doctor is on site (they don't even have to see the patient!)." how can this be? is this only for private insurances or medicare too? thank you all very much for the great information.

I'm on the "other side" of the state. NEPA (Poconos area).

I am relatively new and have some questions re: to billing under my # and the doctors. I am sure some one out there has the answers. 1.) Can an NP see a new patient on her/his own or does the dr. have to see new patients ( in the office). 2.) Currently I am seeing the patients in the office and then, at a later time (either that day or even the next morning) I talk with the dr. and review every patient I saw and explain what I ordered etc and if he wants something additional or different, I would contact the pt. This goes for new and existing patients. Sometimes, if he is in the office, I will discuss it with him at that moment, and he may even come in to the exam room and see the patient if I need him to look at or listen to something. We are billing under my number and of course getting 85% but can we bill at a higher level since he is being consulted on just about every case? 3.) When I discuss the case with him or he comes in and examines the patient, how should I document that? Is it enough to say in my note that this was discussed with dr. and WE have decided to ......? Thank you.

I think there is actually a "sample" or template of a collaborative agreement posted on the Pennsylvania BON website. What part of PA are you from? Just curious as I am from PA too.

:icon_rollOk, I know this is probably a really corny question but here it goes :icon_roll My boss is getting business cards made up for me and asked me how I wanted them written. Should it just be "Nancy Nurse, C.R.N.P." or "Nancy Nurse, M.S.N., C.R.N.P" etc. or should it say FNP or CRNP and then spell out Family Nurse Practitioner etc. See, told you it was corny but I really don't want to make a stupid mistake on the cards. Thanks.

I am unable to get to the page that both of the links lead to. It must be my computer but I don't know how to fix it. thanks

I would love to be able to review the worksheets that David's link leads to, but for some reason I am unable to pull up the page. Can you either repost the links or post the sheets? Thanks

I am wondering if anyone knows of any websites, books etc that may have some case studies (esp cardiac) that I can use. I am a new NP and new to cardiology as well (6 months). I am at the point now where things are settling down and I can now focus on some specific senarios. For example, pt comes in with "xyz" symptoms and "abc" shows up on echo how would you treat it etc. Any ideas? Thanks

This is a great site, thanks. Can you help me understand it? LOL There is the facility charge, the facility limiting charge and the conversion factor. Do I add the facility charge and the conversion factor today to get the payment amount or do I subtract the conversion factor from the facility charge? Thanks.

Thank you all for the great replies. The "fuss" I am referring to has to do with CMS not directly stating "yes" and the board of nursing not specifically stating that the NP can or can't do them. My office manager is leary about having me be the only "licensed" professional in the building while they're being done (for legal reasons of course). The Pennsylvania board of nursing isn't really giving her any direction either. They just keep saying "refer to her scope of practice", which doesn't say much of anything. David, you are such a great resource. Thank you for the guidance. I haven't gotten to the articles yet but I am looking forward to it. Thanks again to everyone. I will keep you all updated on how this progresses.

Does anyone know how much a hospital/physician gets paid to insert a PICC line using ultrasound or fluro? thanks

Can someone help shed some light on this situation. I work for a cardiologist in Pennsylvania and he does stress tests in his office (adenosine, dobutamine and exercise). Can an NP be the "licensed practitioner" supervising the tests or does it have to be the physician. We would like to be able to have the doc go to the hospital and have me be in the office while the tests are being performed (after all, they can bring in more $$$ per day than me making rounds). But CMS isn't giving us any direction one way or the other except to say, check the scope of practice. Well, the scope of practice doesn't specifically state everything an NP can and can not do so where does that leave us? I am wondering if there are any NPs in Pennsylvania that are the only licensed person in the building while the tests are being run. Also, as I am somewhat new the cardiology, why the fuss? Thanks

Thanks for your replies. There is physician back up but by phone only. I do the actual rounding and note writing on the patients. This includes admissions, ER, consults and discharges. Another question I have is, How much do you (everyone else :wink2:) write on a progress note? I usually include VS, labs if current, and assessment (cardiac, resp, GI etc) as well as recommendations etc. This is time consuming and I know it's more than others are writing but I am not sure what the "minimum" should be. I have seen some drs not even open the chart but simply write doing well, VSS, no complaints and then sign it. Any suggestions? Thanks again

I am a new NP. I work for a cardiologist that covers with a primary care group. On call consists of covering the office calls after hours as well as rounding on patients in 3 local hospitals (~ 20 mi radius) on the weekends. The census has been running ~18 - 25 pts. I am totally overwhelmed by this and am wondering what the census is for other NPs when they are on call. The dr. says this isn't bad and I should just "buck up" basically. I would love to know how this compares to others. Please be honest. Am I just overwhelmed or is this crazy. Thanks

I saw an ad for an NP to work for a nursing home. I was wondering if anyone is doing this and if so, what is it like? Do you like it? Is there enough variety and patient needs to warrent a practitioner on a full time daily basis or do you do alot of administrative work to "fill in the gaps".

where can I find out how much insurance companies, medicare etc cover for services without actually asking the billing person in my office? I am paid by the hour but would like to know approximately what I "bring in". It may help in future negotiations but I wouldn't want to "tip my hat" so to speak until the right time. thanks

I just found out that PAs in my state must have a bachelor's degree (it can be in anything) then take 3 semesters of classroom(didactic), then 3 semesters of clinicals.

"But when a patient has multiple allergies that eat through your formulary this program gives me multiple options" Can you explain this please? I have the free trial version of epocrates and am not familiar with this feature or how it works. thanks:)