Lessons Learned From Nurse Practitioner Independent Practice

A Conversation With a Nurse Practitioner Entrepreneur

Joyce A. Hahn, PhD, RN, NEA-BC, FNAP; Wesley Cook, APRN, FNP-BC, CPSN


Nurs Econ. 2018;36(1):18-22. 

In This Article

Lesson 3: Delegate the Tasks of Credentialing But Supervise the Delegation Closely

Credentialing is cumbersome and can take up to 6 months for approval. It is best to enlist a credentialing firm. Choose your credentialing firm carefully. You want to be represented by a firm that will best support the business's interests. Hiring an attorney to work alongside the credentialing company in negotiations is invaluable if not imperative since business negotiation skills are not requisite elements of NP preparation. Be mindful attorneys charge by the hour so determine your priorities and make them clear from the outset. Planning is crucial for cost containment and expectation management alike.

Be certain to have your attorney approve contractual language before signing anything. This ensures all areas that require negotiation are not left without attention. When approaching the payer at any stage, do not assume the payer will understand the role of the NP. You may need to present the business case inclusive of quality data and outcomes literature that NPs are more than "physician extenders" or "mid-level providers."

The negotiation may not succeed this time. Do it anyway, for the sake of the profession and your future negotiations. Business is a long game and credentialing is not straightforward: you have the right to appeal provider-status rejection with the assistance of your legal counsel. Keep in mind rejection is not a final ruling if you have not appealed one or more times. Above all, keep your finger on the pulse of the credentialing process and do not grant signature privileges to anyone. Failing to supervise the process may prove financially detrimental. As we learn in Nursing 101: delegation is not a transfer of responsibility.