ME\r\n \r\nENTREPRENURSES AT SXSW\r\n \r\nHACKATHON\r\n \r\nSHARKTANK\r\n \r\nNP ENTREPRENEURSHIP CONFERENCE\r\n \r\nPAST EVENTS\r\n \r\nBLOG\r\n \r\nLynn Rapsilber\r\nDNP ANP-BC APRN FAANP\r\nLynn Rapsilber DNP ANP-BC APRN FAANP (Diploma in Nursing ‘81 St. Mary’s Hospital School of Nursing, BSN ’91 University of Connecticut, MSN ’98 University of Connecticut) graduated with a Doctorate in Nursing Leadership from Quinnipiac University, May 2016. She received the Benjamin and Juliette Trewin Award for Professional Leadership in Nursing. Dr. Rapsilber’s Portfolio Project “Reimbursement for Nurse Practitioner Services” was selected for presentation at the Eastern Nursing Research Society conference as a poster presentation. Dr. Rapsilber recently received the Quinnipiac Transformational Nurse Leader Alumni Award for 2017 and was the keynote speaker at the DNP hooding ceremony. She is the co-owner of NP Business Consultants, LLC providing dissemination of information regarding reimbursement for nurse practitioner and other health care provider services. She is recognized as an expert on coding and documentation for APRNs. She has presented at local, state and national forums. She is author and educator of NP students and seasoned NPs. Dr. Rapsilber also serves as the Chair of the Connecticut Coalition of Advanced Practice Nurses. Under her leadership, full practice authority for APRNs in the state of Connecticut was attained with the passage of PA 14-12. She is the Connecticut State Representative for the American Association of Nurse Practitioners. She was bestowed induction as a Fellow in the American Association of Nurse Practitioners. She currently works as a GI Nurse Practitioner for Connecticut GI in Torrington, CT.
It is every APRNs fiscal responsibility to understand the revenue stream within a practice. APRN education focuses on the clinical aspects of training and little on the business side of generating revenue for a practice by correct coding and documentation for APRN services. APRN documentation reflects what transpired during the rendering of service. Reimbursement for that service requires utilization of history, physical examination and medical decision-making occurring during the time of service. Knowledge of Current Procedural Terminology (CPT) provides documentation of the “What was done?” This includes: procedures and office visit codes. International Classification of Disease (ICD-10) yields the “Why it was done?” This includes classification of diseases and symptoms. The linkage of CPT and ICD-10 equals medical necessity. Lastly, evaluation and management documentation guidelines provide criteria for level of history, physical examination and medical decision-making performed to secure a billable for the APRN service. Without a thorough understanding in utilization of evaluation and management guidelines, documentation to support CPT and ICD-10 coding levels, practice revenue stream can be affected. When a service is under coded, the documentation provided actually supports a higher level of billable and revenue is lost. When a service is overcoded, the service was overvalued for the documentation rendering and overcharge costing the practice financially, increasing potential liability. This project reviewed documentation based on billables for APRN services pre-intervention. Dissemination of best practices in coding, documentation and reimbursement occurred through a PowerPoint presentation. Evaluation of documentation of billables post intervention is still ongoing. APRNs that can accurately document and code their services bring value to a practice and add to the evidence base for the quality and cost-effectiveness of APRN care.
Diane Gerardi is working in Rhode Island College School of Nursing, USA
Purpose/Background: \r\nNurse preceptors are crucial to development of nursing practice. Traditional orientation programs are not comprehensive enough to ensure competence of new graduates within complex organizations. Evidence demonstrates preceptors have a significant role in transition of new graduates in clinical residency programs (Benner, Sutphen, Leonard, & Day, 2010). \r\n Methodology:\r\nCreation of the Post-Baccalaureate Nurse Residency Program (PBNR) was the impetus for substantial improvement of the Preceptor Program at Providence VA Medical Center (PVAMC). Responding to this need, educators developed a comprehensive, evidence based approach to preceptor training, enrichment and support. \r\nFindings/Outcomes:\r\n\r\nPrior to the program candidates complete a confidential self-assessment. The exercise describes knowledge, skills and attitudes associated with effective preceptors. The candidates are encouraged to reflect on their suitability for the role of preceptor. During the program the self-assessment is reviewed and explored. \r\nA day long educational session conducted three times a year is a critical element of the program. Highlights include testament from a resident about methods his/her preceptor used to facilitate introduction to the Medical Center and nursing practice and an explanation of the mission and purpose of the PBNR program by the director of the PBNR. Throughout the day, interactive activities compliment informative material such as, communication techniques, assessing competency, and giving feedback. \r\nImpact (Clinical/program significance):\r\n\r\nA tool-kit is available on Nursing Sharepoint for additional development of preceptors. Monthly sessions are held for experience sharing and continual growth. \r\n\r\n\r\nSummary/Future Directions:\r\nPreceptors contribute to and are resolute supporters of the PBNR at PVAMC, central to the organization’s efforts to bridge the education-practice gap. Future plans include academic appointment for qualifying preceptors as cooperating faculty at Rhode Island College School of Nursing. \r\n