Reimbursement Issues for Nurse Practitioners Discussion Assignment

Reimbursement Issues for Nurse Practitioners Discussion Assignment

NURS 6565 Week 8 Discussion: Reimbursement Issues for Nurse Practitioners

Reimbursement Issues for Nurse Practitioners Discussion Assignment – Understanding the complex process of accurate coding and billing is essential to a sustainable practice. As NPs, we are ultimately responsible for ensuring all coding and billing is accurate for each patient seen. For this Discussion, you will search the health care literature and summarize a peer-reviewed journal article published within the last five years.

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To prepare Reimbursement Issues for Nurse Practitioners Discussion:

Select one of the following topics:

• o   Applying for Medicare and Medicaid Provider Numbers
• o   Application process for National Provider Identifier Number
• o   Incident to billing
• o   Coding-Evaluation & Management
• o   Fraudulent billing
• o   Billing Self-Pay patients
• o   Managed Care Organizations

Reimbursement Issues for Nurse Practitioners Discussion Assignment

Conduct a search and select a peer-reviewed journal article published within the last five years related to the topic you selected.

Note: For this Discussion, all students are to avoid all written work, which reviews or outlines coding and billing at previous or current worksites as well as previous or current practicum sites.

Post at least 250 words (no introduction or conclusion)

1. a brief summary of the article you selected.(must be a scholarly peer reviewed article no more than 5 yrs old
2. Include the key reimbursement issue addressed and how they would impact the NP in a collaborative practice versus and independent practice.
3.   Discuss an ethical or legal implication(s) associated with your article.

Required Readings

Buppert, C. (2018). Nurse practitioner’s business  practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones  Learning.
Chapter 9, “Reimbursement for Nurse Practitioner Services” (pp. 311-325)

Optional Resources

Buppert, C. (2018). Nurse practitioner’s business  practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones  Learning.

• Chapter 9, “Reimbursement for Nurse Practitioner Services” (pp. 311-325)

NURS 6565 Practicum Journal Wk 8

Each week you will complete a Practicum Journal entry and Time Log that prompts you to reflect on and document your Practicum Experiences.

Practicum Journal

• Continue documenting your Practicum Experiences in your Practicum Journal. Reflect on your practicum experiences and relate them to your Professional Goals and Self-Assessment of Clinical Skills that you identified in Week 1.

Follow journal entry format and choose any illness or patient…..

E.g

Reflect on a patient who presented with a disease. Describe key signs and symptoms that were consistent with this disease. If you diagnosed the patient with the disease, describe your experience in telling the patient that she had the disease, as well as the patient’s reaction to the diagnosis. Explain how the diagnosis might impact the patient’s life short-term and long-term. Include an explanation of the patient’s medical history, drug therapy and treatments, and follow-up care. If you did not have an opportunity to evaluate a patient with this background during the last four weeks, you may select a related case study from a reputable source or reflect on previous clinical experiences.

Reimbursement Issues for Nurse Practitioners Discussion Assignment

Reimbursement Rates and Medical Coding

Assignment 2:Week 6 Practicum Journal: Reimbursement Rates

Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses. As a PMHNP, you will be faced with varying rates that may be different than other health care providers you may work with.

In this Practicum Journal Assignment, you will analyze reimbursement rates for mental health treatments you will likely use in your practice and compare those rates to other provider rates.

Learning Objectives

Students will:

• Analyze reimbursement rates for mental health treatments

To prepare for this Practicum Journal:

• Research reimbursement rates for various treatment modalities.
• Compare NP rates to other provider rates.

For this Practicum Journal:

• Complete the Reimbursement Rate Template in your Learning Resources using the five types of services you are likely to use in your practice.

Reimbursement Rate Template

As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for your time. The CMS sets up codes to identify the type of service you are providing. You will generally complete this task at the end of the visit as you are documenting the visit with the client. Here are examples of the codes to know:

CPT Codes for Psychiatric and Psychological Procedures

HMSA recognizes the following service codes for the reporting of psychiatric and psychological services. (See  for information on how to obtain the books.)

Links to websites that discuss this: