Wiki Credentialing/Billing


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We have a new part time APRN (PNP). She has to work under the supervision of a physician for her first 3 years. She also carries an LPC license for which she has a private practice.

Gainwell told me that she can only have one enrollment and has to update her CT Medicaid enrollment to APRN as her primary taxonomy. Her private practice would then be paid under the outpatient physician fee schedule instead of the behavioral health clinician fee schedule.

Her concern is that she will need MD supervision at her private practice. Is she able to provide independent psychotherapy services at her private practice while simultaneously providing psychiatric medication management services at our clinic under the supervision of our Medical Director?

I've never had this situation before. I am uncertain how to proceed with credentialing her with Medicaid as well as Commercial plans.