APN Strategies to Obtain Reimbursement

• Lobby for state and federal reimbursement legislation, rules & regulations that facilitate APN reimbursement
• Work with the state insurance commission to promote insurance conventions that recognize APN cost-effectiveness and visibility
• Work with regional HCFA staff to interpret federal rules and regulations and give input regarding reimbursement problems
• Work on clarifying the payment mechanisms for APNs who are self-employed or who work in hospitals, clinics, or private practices
• Develop consistent APN education and credential standards
• Form coalitions with other APNs to lobby together for reimbursement changes
• Promote collaborative, best-practice models of health care
  • Be a team player with other health care colleagues
  • Promote the unique contributions of the nursing perspective
  • Identify APNs as advanced practice nurses, not "mid-level providers," "physician extenders," or "non-physician providers"
  • Lobby managed care corporations to allow APNs to be "providers of record"/"providers of choice"
  • Promote full use and identification of APNs as primary care providers
  • Obtain APN representation on Boards of Directors and other committees in MCOs/HMOs
  • Get to know the administrators and coding personnel in your practice
  • Insist that employers use APN provider numbers on billing to each third party payer
  • Keep informed about changes in reimbursement policies and practices
  • Request billing information in an ongoing manner to track APN cost-effectiveness