Optimization of advanced practice clinician billing: the first key step to creating an APC-specific onboarding within a healthcare organization

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Montana State University - Bozeman, College of Nursing


Advanced practice clinicians (APCs) have proven to be a cost-effective solution to meet the demands of increasing needs for providing high-quality healthcare, these clinicians continue to report difficulty transitioning into their role. Organizations that employ APC-specific onboarding programs have resulted in improved role transition with reports of increased provider confidence, increased interdisciplinary collaboration, and improved provider competencies. One healthcare organization sought to develop and implement an APC-specific onboarding program. Problem: A healthcare organization was lacking an APC onboarding program to support and provide professional development for APCs. A needs assessment of 90 APCs in the organization resulted in over 30% of responses, reporting feeling less than confident in the skills to independently select billing codes for patient encounters. Also, 60% of respondents were interested in education for the optimization of billing practices. Methods: After collaborating with organizational stakeholders, it was determined a comprehensive educational intervention would be created. A video series of 15 educational modules was created and disseminated to all APCs along with a post-interventional survey. Results: 7 of the 90 APCs responded to the post-interventional survey resulting in positive, but inconclusive data. Due to slowed billing resulting from the pandemic, billing data was unavailable for analysis during the timeline for the project. Of the survey responses, 57% reported the intervention was useful for providers of all experience levels and 43% reported it was most beneficial for newly licensed or hired providers. Conclusions: While the project cannot state the intervention resulted in the optimization of APC billing practices, a comprehensive educational program was created and disseminated with positive responses from APCs participating in the survey. More work needs to be done to determine the effects of the education on billing practices. However, positive survey feedback indicates the intervention would be a feasible, beneficial first step and contributed to the development of a comprehensive onboarding program for all APCs within a healthcare organization.




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