Regulations For Nurse Practitioners Essay Assignment

Discussion Six

What are the considerations a Nurse Practitioner has to investigate before beginning an independent business? Consider the inpatient and outpatient arena. Make sure to discuss your state’s regulations for Nurse Practitioners. How is a bill for services submitted?

A nurse practitioner can engage in a range of independent business activities to include private practice, nurse freelance, medical spa, homecare agency, cannabis agency, intravenous infusions, legal nurse consultant, specialized care provider, independent massage therapy, and so on. Each of these independent business opportunities leverage the unique qualities and strengths that nurse practitioners possess to include conflict resolution, organizational, time management, communication, and critical thinking skills (DeNisco, 2023). Regulations For Nurse Practitioners Essay Assignment

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Engaging in any business activities requires a good understanding of the relevant legal provisions. There is a need to understand whether the state regulations allow nurses to have full practice authority or if they are allowed restricted or reduced practice authority. A full authority practice environment permits nurses to engage in all practice activities that their education, certification and competence would allow, such as evaluating patients, ordering and interpreting diagnostic tests, diagnosing patients, and initiating and managing treatments to include prescribing medication and controlled substances. In states with reduced practice environment, the regulations reduce the ability of nurse practitioners to engage in at least one element of their practice with the requirement for career-long regulated collaborative agreement with another health provider. In states with restricted practice environment, the regulations restrict the ability of nurse practitioners to engage in at least one element of nurse practitioner practice, and requires career-long supervision by another provider (Zaccagnini & Pechacek, 2019).

Florida State has a restricted practice environment. This implies that the state practice and licensure laws restrict the ability of nurse practitioners to engage in at least one element of professional practice. Nurse practitioners are supervised by physicians in an arrangement that must be outlined in writing. The arrangement has the physician overseeing not more than five practice locations, to include any personal practice (Berkowitz, 2021). Regulations For Nurse Practitioners Essay Assignment

In addition, there is a need to consider the reimbursement model in private practice. Nurses are not reimbursed directly for their nursing care services. That is despite nurses playing a critical role in integrating efficiency, safety and quality of services. This results in nursing costs being bundled into other costs. Rather than billing for actual nursing services provided to the patient or for the amount of time spent in providing nursing care, the cost of nursing care is imbed into line items for other costs such as room and board (Buppert, 2020).

Still, nurses can bill directly for reimbursement of care costs. This involves identifying the right ICD and CP codes and submitting them for reimbursement. This requires a good understanding of the coding strategies that affect billing and reimbursement for care. In this case, meeting the requirement for complete and accurate documentation is critical to supporting the reimbursement claim. It is important to note that billing and coding requirements vary across states and individual practices because of institutional policies, payor contracts, state regulations, and federal laws. For nurse practitioners in Florida and other restricted and reduced practice environments, the billing is incident-to. Incident-to billing is applied when the nurse practitioner provides services when collaborating with a physician in which case the physician is considered to have developed the treatment plan and supervised the nurse practitioner. For that matter, the physician would be the billing provider while the nurse practitioner would be the rendering provider. In other words, the care and quality measures are credited to the physician, not the nurse practitioner, with any bonus for care similarly going to the physician (Green, 2020). Regulations For Nurse Practitioners Essay Assignment

References

Berkowitz, E. N. (2021). Essentials of Health Care Marketing (5^th ed.). Jones & Bartlett Learning.

Buppert, C. (2020). Nurse Practitioner’s Business Practice and Legal Guide. Jones & Bartlett Learning.

DeNisco, S. M. (2023). Advanced Practice Nursing: Essential Knowledge for the Profession (5^th ed.). Jones & Bartlett Learning, LLC.

Green, M. (2020). Understanding Health Insurance: A Guide to Billing and Reimbursement – 2020. Cengage Learning.

Zaccagnini, M., & Pechacek, J. M. (Eds.) (2019). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing (4^th ed.). Jones & Bartlett Learning, LLC. Regulations For Nurse Practitioners Essay Assignment