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BarbaraNP

BarbaraNP

NP Business Coach, Mentor, Business Ed.
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BarbaraNP specializes in NP Business Coach, Mentor, Business Ed..

Barbara C Phillips, NP, FAANP is the Founder of Nurse Practitioner Business Owner (NPBO™) providing business education, resources and support for entrepreneurial and employed Advanced Practice Clinicians. She believes all clinicians are a “business” and thus even the employed clinician will excel with basic business and marketing education. She can be reached at NPBusiness.ORG She speaks, writes, and teaches on topics pertaining to the professional and business development of nurse practitioners including starting and growing a clinical and non-clinical business, contracts, negotiations, basic business skills, marketing and social media to name a few. More interesting stuff: Baby Boomer, Gemini, Mom of an Adult Son, #1 Daughter, Left-Handed; Photographer, Birder, and loves all things estuary and beach.

BarbaraNP's Latest Activity

  1. BarbaraNP

    LLC?

    If you are working as an independent contractor, you ARE your own business. As an IC, you must pay your own taxes and your own benefits. Some consider it a gray area if you are not organized as an LLC or PC as opposed to being a sole proprietor (the later does not provide you with any protection in terms of your assets). As an LLC, you can elect "flow through taxation", which makes it somewhat similar to how you pay your taxes. In most cases, you are not paying more taxes, but will likely pay less taxes as you'll have several tax deductions you can take as a business owner (and yes, that does mean the IC). I hope this makes sense. It's easier for me to talk about rather than write about. BTW...if it looks like you might not be really be an IC, both you and the company that is using your service potentially could face fines with the IRS. BarbaraNP
  2. BarbaraNP

    Overheard "You're there to make money, not to talk," in clinical

    As an NP who teaches others about having their own businesses and practices, I'd like to chime in here. While working as an RN (and later as an NP) being paid an hourly wage, or even when on salary, I never worried about the overhead cost of seeing patients. Now, as a practice owner, I understand the reality all too well that time truly does equal money. Unfortunately, not everyone understands this reality. Stop for a moment and consider the overhead (ie, cost to run the business) of any practice, hospital, community clinic. Overhead include (and are not limited to): lease/mortgage; salaries and taxes (often the highest/2nd highest expenditure); utilities (heat/air, water, sewer, garbage); phone and internet access; liability and business insurances; licenses; housekeeping; office supplies; medical supplies; lab costs, including those utilized for POC); billing personnel or billing service (quite high usually); professional services such as the CPA and attorney and a myriad of other costs...before the practice owner ever gets a dime. Now look at the other side of the equation: a practice owner only makes money when patients are seen (unless you are seeing pts under a capitated plan as was explained by dudette10). There are several ways to look at this: cost per patient, cost per day, break even points. For example, (using made up round numbers to make this easy). If the overhead cost per month is $5,000 (this would be a very small office), and your average reimbursement is $40.00 (it's often lower than this for Medicare/Medicaid), then the practice (and often the practice owner) does not make any money until 125 pts are seen that month. However, just because the patients are seen, does not guarantee that the practice will get paid. I am only half joking when I say that insurance companies are not in business to pay your claims. There are many more variables that go into this, but I write this to give an example of what every practice owner must consider. As nurses and nurse practitioners who are employed, we would do well to learn a bit about the business of healthcare. No one can provide services for free. Even if you volunteered your time entirely, someone has to pay for the cost of providing the service. There is no such thing as free health care. Period. Someone is paying. And as a professional, don't you deserve to be paid?
  3. I just returned from the AANP meeting - wonderful as usual. One of the things I kept hearing about is how many NPs there are in the country. The numbers I've found vary between 135,000-158,000 (AANP, ACNP, Pearson Report). None of these reports can give us any numbers of how many NPs are in business or wish to be in business. Thus...the National NP Business Survey! The National NP Business Survey (sponsored by NPBO™) is directed toward NPs who have a clinical or non-clinical business, or are thinking of starting a business in the next 5 years. This survey will take no more than 5 minutes to complete, please take it today and pass it on to your colleagues. Make sure you are counted! http://www.NPBusinessSurvey.com Thanks, BarbaraNP
  4. BarbaraNP

    What does prescribe only mean?

    I believe they mean you can only prescribe the medication. You cannot dispense it from your office. BarbaraNP
  5. BarbaraNP

    geriatric nurse practioners

    Another thought...in your ANP program, you can do lots of gero. You can also focus on gero in your CE once you have your ANP. I agree that with an ANP you will be far more flexible. I started about as GNP and went back to get FNP. Not to work with kids (I don't), but because I wanted to work with adults of all ages, AND have flexibility. My practice now is adults, with a heavy load of gero. Keep in mind too...younger folks are being admitted to LTC...being an ANP will allow you to see some of the young ones. When I got interested in gero, my coworkers in critical care (where I had been for 15 yrs as CCRN) thought I had lost it and "failed". They could not be further from the truth. It takes great skill to be able to diagnosis and treat, problem solve and support patients, family and staff. The furture of GNPs is bright. You can work in LTC, Assisted Living, House call practices, and private offices to name a few. You can work for someone, or for yourself. The shortage in this specialty area is severe. If you enjoy gero...go for it. Don't mind your classmates...it's your work, you life. Do what gives you joy. HTH, BarbaraNP GNP 1988 FNP 1998
  6. BarbaraNP

    medicare billing

    Of all the applications I ever had to do, Medicare was perhaps the most frustrating. It can take 90-120 days to get your Medicare #. The good news is that you begin to see patients and hold the bills until the numbers come through. BarbaraNP
  7. BarbaraNP

    Insurance Credentialing. . .HELP!

    Credentialing is going to be a bit different from state to state as far as who you can credential with and what their requirements are. I happen to believe we all should be billing under our OWN credentials and not the physicians. It's one of the things that keeps us invisible. Credentialing can be a pain. Often times there will be someone in the office to help, but if it's a small office there is going to be less help. CAQH is relatively easy. The info that you needed for them, is what you will need for everyone. In our state (WA), there is a state provider application we use for ALL insurances...I just make copies of the parts I can. Medicare and Medicaid are a bit different, but I'm sure that surprises no one. The basic info is the same however. It does take a while. I often advise NPs to start this ASAP when opening their own practices. Keep copies of EVERYTHNG and keep a spreadsheet of when things were sent, the person you need to contact, when you should be following up etc. Most of all...breathe. Best wishes, BarbaraNP
  8. BarbaraNP

    HELP!! GNP ANCC boards offer no review material

    Check http://www.fhea.com and http://www.apea.com I took my exam so many years ago, I don't know what I studied. Sorry I couldn't give you more info. BarbaraNP
  9. BarbaraNP

    Entrepreneur in waiting

    It's a great idea. We all know that the need for assistance as we get older is growing and growing. There is not going to be enough assistance for my generation (Boomer!). You will need to keep your eye on the changes in reimbursement and adjust your plans as needed. I might suggest that you follow closely some of these facilities, maybe even volunteer/shadow the owners/administrators in order to get a good idea of their day-to-day challenges. In many states, you may also need to obtain an administrators license of sorts. Best wishes! BarbaraNP
  10. BarbaraNP

    What is next please?

    You may need to get legal assistance for your corporation documents depending on what is needed for your location. If you want to do it yourself, NOLO publishes several books on this. I'd also closely following Medicare's Home Health Agency center : http://www.cms.hhs.gov/center/hha.asp BarbaraNP
  11. The Medicare contractor for Texas is: http://www.trailblazerhealth.com/. You may be able to find the rates you are looking for there. You will need to know CPT codes. For Medicaid, you should be able to find the fee schedule. Most state have them listed. You might also check LeaRae's website (http://www.Nurse-Entrepreneur-Network.com)...I believe there are a few RN's who own their own agencies there. Best wishes! BarbaraNP
  12. BarbaraNP

    Have DEA number, where to get prescription pad?

    Medicare and Medicaid Numbers are different from your NPI. Even if you are not applying for Medicare and Medicaid, you need to have a NPI number. You'll need it for everything else. Apply here for your NPI Number: https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart BarbaraNP
  13. BarbaraNP

    FNP but work in Geriatrics?

    I started as a GNP (certificate) and later went back to school for FNP. I much prefer adults and geriatrics. I have my own practice, a good percentage of my pts are geri and I also see pts in ALF's (all geri). BarbaraNP
  14. BarbaraNP

    nursing home/geriatrics

    Try this: http://www.geriatricsatyourfingertips.org/
  15. BarbaraNP

    Patient Teaching Guide: Coumadin Therapy

    Thanks for the teaching material! You are correct...it is nurses and nurse practitioners that teach patients. May I suggest changing the "ask your doctor" to "ask your heatlh care provider"? As a NP, I often prescribe and manage patients on coumadin - and I do so independently - meaning there are no physicians involved. There is something subtle in the words "ask your doctor" that underminds both nurses and nurse practitioners. Thanks, BarbaraNP
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