Wiki Hiring NP Advice in SoCal

[juncruz]

Hello Friends,

This is my first post. I appreciate in advance all your responses. I am thinking of bringing on an NP to assist our office located in Southern California. Our doctor is slowing down due to age.

Feel free to respond with direct advice or resources to find answers on my own. I don't my doing homework.

Here are my questions:

1. What does the collaborating relationship look like between the physician and NP in terms of seeing patients. Does the Physician have to review all the assessments and plans of the NP?
2. Does an NP need their own:

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- malpractice insurance?

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- DEA license?

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- If so who pays?
3. How is billing for NP? i.e. incident to services I think are 85% is this correct? What if the services are conducted exclusively by the NP if this is even possible?

Thank you again!

 

[Pam Warren]

You will need to check the nurse practice act in your state. Here in NH, APRNs can work independently without a physician supervisor.

A NPP needs their own malpractice and DEA #, depending on if they have prescriptive priveleges in your state. Who pays for what depends on your practice structure and the arrangement set up as part of the employment agreement. There's no fast rule, but if you pay for it as a condition of employment, you'll be sure it doesn't lapse and put your practice at risk.
In states where NPPs are able to have their own Medicare billing numbers, (independently practicing), you don't have to follow any incident-to rules with regards to supervision. CMS reimbursement is 85% of physcians. But the doc doesn't have to be in the suite at the same time, or sign off on the charts.

The IOMs list all the criteria for NPP providers on the CMS website. Check also with your state nursing board. And commercial payers often have different criteria.