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A Psychiatrist’s Toolkit: Supervising NPs and PAs

Nurse Practitioners and Physician Assistants (NP/PA) have long played an important role in the provision of healthcare in North Carolina. NP/PAs have worked with psychiatrists in every practice setting—private practice, institutions, and particularly community mental health agencies. The traditional multi-disciplinary team approach of psychiatric care has instilled an appreciation for and reliance upon all clinicians in the care of this complex patient population, making the field uniquely situated to embrace the evolving health care delivery system of team-based care, collaborative care, accountable care, and shared savings. To that end, psychiatry’s ability to work with other professionals, to assess skills, and to assist in their development will be even more crucial.

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Medicare Resources

Medicare was created in 1965 as part of the Social Security Act. The program was divided into two parts. Part A is hospital insurance and helps to pay for care provided in a hospital, skilled nursing facility, nursing home, or hospice. It covers the room, board, and ancillary charges billed directly by the facility. The covered portion of expenses is based on the number of days the patient has received care. Part B covers the professional services of physicians and nonphysician healthcare providers and a variety of outpatient services including x-rays, laboratory work, and durable medical equipment. As a psychiatrist, you will almost always be working with Part B.

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PDL and Prior Authorization

NCPA’s Executive Council convened a task force in 2015 on prior authorizations (PAs) and the Medicaid preferred drug list (PDL) in response to members’ concerns about the ever-increasing number of prior authorizations being required by insurers. We've compiled several resources to assist with PAs (including appeals) and have developed guidelines for responsible prescribing. 

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Practice Management

We've compiled several resources to assist with your Practice Management needs. Should you have additional questions, the APA has a Practice Management Helpline that puts you in contact with staff in the APA’s Office of Healthcare Systems and Financing who will provide assistance with problems you are encountering in your practice. Call 800-343-4671.

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Medicaid & Community Psychiatry Resources

Working with Medicaid can be confusing. We have tried to compile resources to help you navigate the public mental health system in North Carolina. Of course, please contact us if you encounter problems or have concerns not addressed by these resources. 

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