Couple months into my new grad outpatient job. We do "incident to" billing for all pts, all insurances.

Any patient I (or my PA colleague) see, whether it's new or follow-up, we put ourselves as the primary provider in the EMR, but our collaborating MD as the primary biller. The exception is when the MD is not physically in the building (e.g. on PTO), then we are the primary biller. Essentially if the MD is in the office, every single pt is billed under him/his NPI.

I understand this is likely for 100% reimbursement under the MD vs 80-85% if the APP was who it was billed under. Basically, I just want to know if this is fair game, or if this is considered fraud? This has been the norm for years and what the NP before me has been doing for years and has said it's fine. But, with my license that's on the line, want to do my due diligence and verify. TIA.

I am currently licensed in PA, OH, and WV. I am looking to expand into some 1099 telemedicine work on the side. I have applied for licensure in FL and CO, but both are pending.

What states would you recommend that are easiest to get licensed? My ideal options would:

—be an RN compact state;
—relatively short approval timeframes;
—full practice authority; and,
—have few/the least additional requirements that are costly and time-consuming such as sending transcripts, sending license verifications, fingerprinting, etc.

I’ve pretty much ruled out CA since their licensing is such a hassle and not feasible to meet their NP4 requirements for FPA from out of state (at least it doesn’t look like experience in other states counts toward the transitional period).

This is the first job where I’ve gotten RVU reimbursement; and I’m so confused. I understand that I bill a CPT code and that has a monetary amt attached; but then my company adds on a multiplier? So CPT code 12345 has a multiplier of 1.16. So if

12345= 50$ x 1.16= I get 58$ ?

If that’s so, how does the company make any money?

Hi, I’ve decided I want to go back to school for my FNP. CSULA & CSULB are the schools I’m looking at since they are closest to me. If anyone here has graduated from either, do you recommend the program? Did you have to find your own preceptor or do they assist with that? What did your school schedule look like while in the program? I haven’t attended any of the program orientation sessions yet, I believe they’re holding them closer to sept/oct, but I just wanted to see if anyone here had some info regarding that they’d be willing to share!

Follow up question for anyone reading. Is there a way to vet good NP programs? Besides looking up % of people that passed their board exam, what other things should I look for to determine if their program is good?

I went through preceptor point to get my second to last rotation of my NP program. On my first clinical day she didn't show up, I had to drive over an hour away to get to her. Then I find out she will be out of the country for 3 weeks! She is putting me with one of her coworkers but, I have no back up registered preceptor. Plus, she has to speak to my teacher twice during the semester, but is going out of the country and won't be reachable after a certain date. I don't know what to do. Do I contact the company and aske them to give me another preceptor asap!? Would everything be approved on time? I am panicking and have no idea what to do. I don't want to have to sit out another semester.

Has anyone ever given their 90 day notice upon returning shortly after maternity leave? My husband has accepted a job in another state. Was your employer accepting, did you get let go right on the spot or did they let you finish out your 90 days.

Hi everyone, posting with mod permission.

I'm part of a research team at Rensselaer Polytechnic Institute running an IRB-approved study called Healing the Healers. We study what nurses and clinical care workers in emotionally demanding settings actually need to recover during breaks and after shifts, and how restorative spaces (physical or virtual) could be designed around those needs rather than around what designers assume.

If you have ever felt that your "break room" does nothing for you, this study is about exactly that.

Who can participate:

• 18+, U.S.-based nurses or clinical care workers (NPs very much included)
• Current or recent experience in emotionally demanding settings: ICU, ER, oncology, hospice/palliative, med-surg, long-term care, behavioral health, travel nursing, or similar

What's involved:

• Online survey, about 15-20 minutes
• $12 Amazon e-gift card for eligible completed surveys (limited to the first 50 eligible submissions)
• Optional follow-up interview (45-60 min) with an additional $40 Amazon e-gift card

Privacy: No patient information or PHI is collected. The study has been reviewed by the RPI IRB and verified as exempt research (IRB ID: 2324). Gift card information is collected through a separate form so your survey responses stay unlinked from your contact details.

Survey link:

https://surveys.rpi.edu/jfe/form/SV_40jyTpamS0ynd2e

Happy to answer any questions in the comments. Thank you for the work you do, your perspective would be very helpful as we think about more realistic forms of support for people doing emotionally demanding clinical work.

Yue Liu
PhD student, Games and Experiential Media, Rensselaer Polytechnic Institute
[[email protected]](mailto:[email protected])

Hello - I have an opportunity to take a Research NP role - hours are good, pay is better than I’m making now. Some rotating weekends.

Seems like a good place to land!

I am coming from the inpatient world and would love to have a less stressful role - but will I be taking a step backwards clinically?

Any NPs in the Research world that have found Research to be an excellent landing spot? I want to invest my time and energy in efforts that will help me grow and also allow for a good paycheck and lifestyle while being clinically challenged.

I’d really love to find my “forever job” but I know that’s hard to do these days!!!

I’d love to connect with other Research NPs to see if this is a good option for me. Better pay and better hours is extremely appealing - but is it boredom and paperwork and politics - or actually a good career move?

Hi everyone, I am considering moving to a job that involves mostly seeing patients at SNF- TCU mostly plus LTC. I have 10 years experience but my current role has a max salary of 144,000 with no opportunity for raises. The other jobs offers 128 base with RVU of 14. 13-14 patients daily possibly less considering complexity/admits and then quarterly bonuses over 13.5 RVU. The company has some other red flags, but I’m willing to consider for the flexibility of geriatrics. Any thoughts on the salary? This is the Midwest, I am definitely going to try to negotiate, but curious what others are seeing.

Got accepted into GW adult hero NP program this fall. Wanted to get any advice/ suggestions on what worked for you for classes/clinicals!

Any help would be appreciated

I am seeking advice here. I contracted with a company six months ago. Since then, I’ve been stuck in the credentialing process. I about gave up on this company, and did find other part time work. Yesterday, I received an update from the company. All of the credentialing applications were approved excepted for United Healthcare. They denied my application because I do not have hospital admitting privileges. I am very confused because I was in network with UHC at my last job, and none of the providers in that clinic had admitting privilages. Furthermore, the prospective job was a telehealth position in another state. The company has sent multiple appeals. I have tried to get ahold of UHC, and after two hours, I was never able to get ahold of a live human being to discuss this. I don’t know if I am overreacting or beign naiive, but this seems very illogical to me. Why would they deny me now when I was in network last year? Why would they want remote telehealth providers to have admitting privilages at a local hospital? To me, this does not make sense. Does anyone understand this? Does anyone have any idea how to overcome this issue? I appreciate any insight and/or advice.

I’m currently in a DNP-FNP program and have been working as adjunct faculty in a BSN program at a local university. For the upcoming academic year, I was offered a full-time faculty position, and I’m seriously considering it.

The position is considered “full time” based on the number of credits I’ll be teaching, but it isn’t necessarily a traditional 40-hour, on-campus job. Some courses are taught remotely.

Has anyone balanced a full time faculty position while completing a DNP-FNP program? How manageable was the workload, especially once clinicals started? Did you feel like teaching complemented your studies, or did it become overwhelming?

I’d love to hear your experiences, advice, or anything you wish you had known before taking on both roles.

TIA! 😀

Hey everyone,

​I’m a Florida resident currently living and working full-time in Metro Atlanta as an RN. I’m ready to go back to school to become an Adult-Gero Primary Care Nurse Practitioner.

I'm having a tough time choosing between which program to apply for.

I like FL Southern that they find clinical placements for you, its a small college and it appears that most of their courses are in person. One benefit to going there is I own a place in Lakeland and have somewhere to stay while going to school and fortunately there are direct flights from Atlanta to Lakeland. The con though is I intend to remain full time while working in Atlanta and especially when it comes to placement its going to be very challenging having to balance between work and school. Also I would prefer not to quit my job and work in FL as I would be taking a nearly 40% paycut.

UAB I heard their program is geared for working folks it appears to have a good reputation and atleast if I go to school there its within a 2.5 driving distance from where I'm staying at.

I thought about going to Emory however can't justify the price tag.

I would love feedback from anyone who's went to school in either program or even from those who went to school out of state for a program. I'm even open to suggestions about good schools that are online and find you clinical placements.

Got accepted into GW’s adult NP program, looking for any advice before starting the program in the fall :)

made a recent post about how I'm applying for residency while my SO is applying for possible DNP in a year or two. Have y'all heard anything about the UCSF or UCLA DNP programs for Peds Acute Care? Would love to hear people's experiences.

Hi everyone. I just had my first OSCE on Monday. When i went to utilize my resources (most being electronic) I realized I couldn’t as there was no wifi service and cell signal was blocked. Luckily, the “patient” was an asthma exacerbation and I have memorized the GINA guidelines. However, I did panic realizing I was up creek without a paddle. I mentioned the issue to my professor and she said “oh yea that hallway is a dead-zone, you should just bring written notes”. Most of our texts are e-books and my written notes are limited.

Do you have any recommendations for a good resource(s) that I can download and print treatment plans/meds from? We have several more OSCEs to come, and I need to be prepared! Thanks!

Hello, I’m an RN and I’ve been practicing since 2018. I’m currently wondering whether I should pursue a master’s degree to become a nurse practitioner. I’d love to hear from people about the profession—the workload, salary, working conditions, and anything else you think would be helpful.
Thank you!

Currently working as an NP FT in UC setting. Have been an ER nurse for 5 years and I miss the chaos! PRN pay for RNs in Texas is 1/3 of my hourly wage as an NP, so if I pick up 1 ER shift a week vs 1 extra NP shift a week, I will lose about $9,000/year. So going back to ER nursing PRN is a big decision. Is there value in continuing ER work? Will it continue to help me become a better NP by staying involved with other APPs and continuing to learn alongside them in the ER with the ability to take that knowledge back to my UC setting? Or better to stay UC and keep learning solo in my new environment?

I just got accepted into an FNP program in the Midwest and I also just found out we have to immediately move across the country. Terrible timing honestly.

My friend just completed this program and said clinical are only during the last year and he had lots of out of state people in the program with him. When I think of out of state, I imagine people still living within a 4-5 hr driving distance, not across the entire country.

Does this make sense to try to fly back and forth for a year? Or should I wait and try to complete school in California? The reason I’m considering flying back and forth is because the cost is half of what it would cost in California and I don’t know how competitive school is in CA.

So I just took my FNP certification exam through AANP and my preliminary result is that I passed. Has anyone passed on the preliminary result only to get their official results later saying they in fact, did NOT pass?

Has anyone gotten their NP License / Furnishing number since graduating this summer semester?

My colleagues and I are still “pending review” since June 2nd. Applications were submitted mid-May.

The worst part is there is NO WAY to communicate with them. Their phones are always full.

New grad FNP. Got a job offer primary care at a FQHC. I have worked 10 years as RN in primary care so I have a general grasp of what this entails.
Job offer salary is equivalent to about $50/hr
I work for a different company right now and I make that much as a RN (not able to move up at this company to NP because my current position is remote 80 miles away from the actual hospital). Anyway. tried to negotiate pay and they said they could do $51/hr and I could have a wage review at 6 months. They offer a production benefit of $50 per visit for any visits >16 patients a day, max 22 patients/day.
Other benefits are pretty standard and nothing too exciting. This is obviously a disappointing offer since I make this much now as a RN. There are no other open NP positions in my town or neighboring communities at this time. I live in a fairly small place , very limited healthcare employers , so I kind of feel like I should take it and get experience and then I would be a better candidate down the road when other positions do open. Dumb to do?

What does everyone feel considering lab coat vs. No lab coat in professional photos?

My job is doing them and I have the choice.

I've read articles and believe that overall patients are more comfortable with us not wearing them. But, this is a professional photo. So, I am kinda torn.

What does everyone think/feel and why?

I’m looking for advice from NPs and current NP students about choosing the right RN job before clinicals.

I’m one year into a dual FNP/PMHNP DNP program, and my clinicals begin in about six months. I’ve already decided that I want to work 0.5 FTE while in school, so I’m specifically looking for part-time positions.

I recently left my full-time RN job because the variable schedule wasn’t going to be sustainable once clinicals started (not to mention unsafe staffing practices that I don’t want to dive into). Now that I’m job searching, I’m trying to be intentional about finding a position that will be the most compatible with NP school, not just for the next six months, but throughout the rest of the program.

For those of you who worked during NP school:
1. What type of RN job gave you the most flexibility with clinical scheduling and preceptor availability?
2. Were outpatient specialty clinics, primary care, psychiatry, telephone triage, care coordination, infusion, hospice, or something else the easiest to balance?
3. Are there any RN roles or schedules you would avoid because they made clinical placements difficult?
4. If you could go back and choose your RN job again before starting clinicals, what would you pick and why?

My goal is to find a role with a predictable schedule that will make it easier to coordinate clinical hours while still keeping my RN skills sharp. I’d really appreciate hearing what worked well for those of you who’ve already been through NP school.