10/15/2014. You can create...your work...your future



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Innovation in Advanced Practice Nursing Presented by Karen Finck, APRN, CNS Mental Health Counseling Services Creating a Private Practice You are approaching the world on a different level Your education Your license Your certification Give you options When you add yourself Your passion Your interests The desire of your heart You can create......your work...your future You can be INNOVATIVE Creative new solutions are the future in healthcare Right now we are in an exciting time in health care It is a time of Integration Mind Body Spirit Holistic Health Care Technology Genetics Knowledge 1

The human brain is the most complex thing we have discovered in our universe James Watson Two Regions of our Brains Left Right Hemisphere Hemisphere Rational Analytical Logical Non-Linear Intuitive Holistic Separated by the Corpus Callosum (300 million nerve fibers) Left brain dominated society for the past 100 years Daniel Pink A Whole New Mind The Conceptual Age 18 th Century Agricultural Age 19 th Century Industrial Age 20 th Century Information Age 21 st Century Conceptual Age In the conceptual age it will be helpful to develop six high concept - high touch senses 6 High Concept High Touch Senses Design Story Symphony Empathy Play Meaning They will guide our lives & shape our world 2

Design Combine Function & Beauty Story Context Enriched by Emotion Stories Teach Easier to Remember than Facts Story Clients / Patients have Stories Nurses have Stories Healing Stories Symphony Put together the pieces and see relationships in unrelated things Broad Patterns Big Picture Symphony Brainstorming Quantity Lots of Ideas Encourage wild ideas Be visual Defer Judgment Build on each other s suggestions Empathy Imagine yourself in someone else s position and intuit what they are feeling Important Role in Healing Nurses are famous for having empathy 3

Play Fun, Games, Laughter, Humor, Light Attitude, Joyful Meaning Spirituality: The basic desire to find meaning and purpose in one s life Meaning The purpose of life is to seek happiness ~The Dali Lama As Nurses, if we develop those six senses as we enter the Conceptual Age, we will continue to evolve in both our personal and professional lives Making the decision "Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people will feel secure around you." ~ Maryanne Williamson ~ 4

Creating a private practice Education Nursing License ANCC Accreditation DEA License Collaborative agreement with MD if prescribing January 1, 2015 Malpractice Insurance Cost varies with specialty Typical $1,000,000 / $6,000,000 coverage Average cost $700 $2,000 a year for prescribing About $400-600 for psychotherapy Employer ID Number (EIN) Tax ID Number Can be Social Security Number Can apply per phone, mail, or online www.irs.ustreas.gov State Tax ID Number Needed for MNCare Provider tax-2% from health care providers Paid on a quarterly basis Payments done through the Internet www.taxes.state.mn.us What form will your practice take? Work with a group? Collaborative private practice 5

Legal Structure Incorporation LLC PA Book Lawyer Fees Name of your business Register your name http://www.revenue.state.mn.us/ Decide if you want to get paid by Insurance Reimbursement or Cash? What services do you offer? Who are your clients? What geographical area are you in? Insurance Provider Gives you a referral base to get clients Listing on their website Connects you with other providers Easier for clients to find you Cash-paying Clients Smaller referral base Are you willing to negotiate on fees? Economic climate Location will make a difference Options for Payment Have client submit own form to the insurance company (need a Superbill) OR You submit to the insurance company and collect the rest ( copays, deductibles, etc) 6

Superbill b i l l Includes the following Provider name, address, Tax ID number Service provided Length of service Date and Location of Service Client name and insurance information Contact insurance companies to become a contracted provider An in-network network provider Credentialing to Become an In-Network Provider Takes an average of 3-4 months to get status as a provider If already credentialed through an organization, it may be easier to get extended into a private practice situation Credentialing Go to MN Credentialing Collaborative Complete application process online Complete specific information for the insurance company CAQH National Credentialing Some insurance companies through this website Credentialing Recredentialing every 2-3 years Insurance companies initiate recredentialing process 7

Separate Application Minnesota Health Care Programs (MHCP) Medical Assistance MN Care Separate Application Medicare PECOS Billing All billing for health care must be electronic in the state of Minnesota Health Records Documentation System EHR Practice Management Billing Scheduling Collections Will you do it? Will you use a collection agency? Marketing Yourself Referral network Word of mouth Website Get Domain GoDaddy.com Brochures Business Cards 8

Tell your story Create your milieu Office Space Warm and inviting? Clean and Clinical? Reception Area Coffee Water Tea Privacy Sound Music HIPAA Policies and Procedures Forms Training Business Associate Agreements Communications with Clients HIPAA Compliant Email Text Cell Phone EHR Portal Receptionist or Receptionist Sign Please come in, sit down, help yourself to coffee. The therapist will be with you shortly. Reimbursement Group 60 / 40% Income $83,200 $104,000 $124,800 $200,000 9

Private Practice Benefits Flexible Scheduling Set your own hours Vacations at will Control your practice See the clients you want Private Practice Financial Analysis No Workers Compensation (can buy your own policy) No unemployment 7.5% more tax Purchase your own health insurance Collaboration Who will do lab work? Who will do genetic testing? Who will fill prescriptions? Who will you refer to? Coverage Don t get isolated Consultation Education Support System Establishing a Private Practice requires time and energy It is a journey worth taking Contact Us... Mental Health Counseling Services 615 First Avenue NE, Suite 310 Minneapolis, MN 55413 Tel: 612-436-0295 Fax: 612-436-0163 www.healthcounselingservices.com hcs@healthcounselingservices.com 60 10