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Cover Story: Advanced Practice Providers’ (APPs)

Increased Practice Means Increased Risk

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“Primary care and behavioral health account for over 80% of these limits are still affordable,” says Murphy.
all NP claims but the top claim payouts for nurse practitioners Advanced practice providers, like all medical providers,
is in the area of neonatal and obstetrics care where the average should have a trusted healthcare insurance specialist to provide
payment as of 2016 was $630,000,” he says. “This number has guidance with navigating the complexities of the medical pro-
increased as have all claim payments and claims expenses relat- fessional liability insurance world.
ed to nurse practitioners.” “They should also have a trusted healthcare legal expert for
CNA/NSO completed a claims study in October 2017 with constructing and reviewing all healthcare contracts,” adds
some of the following details: Nurse practitioner average claim Murphy. “The medical profession has become more complex
indemnity payments rose 12% from 2012 to 2017. The total over the past ten years with increased regulation such as HIPAA
number of NP claims rose 27% in that same time period and the and HITECH, and consolidation. APP’s, like all medical profes-
average claim expense and legal payment rose almost 30%. sionals, need experienced and trustworthy assistance to avoid
The following are strategies all Advanced Practice Providers the pitfalls of the rapidly changing landscape.”
should follow to prevent claims: The scope of practice for nurse practitioners varies from state
1. Practice within the requirements of your state NP guide- to state. Currently, twenty three states allow NPs to practice
lines and laws. with full authority and no physician oversight. Seventeen states
2. Document all conversations and treatments objectively, allow reduced practice and the remainder, including Florida,
timely, accurately, and legibly. are restricting NPs’ practices, requiring the NPs to have physi-
3. Never alter any portion of the medical record, unless it is cian oversight of their practice.
critical to the patient care and treatment. If this is necessary, be
sure to properly document and date the delayed entry. For more information, contact Tom Murphy or Matt Gracey at
When faced with the knowledge of an incident or actual (800) 966-2120 or visit dannagracey.com.
claim, do not speak with anyone regarding the issue until you
have spoken to your insurance professional or legal counsel.
Do not change the medical record in any way and never agree
to a conversation or deposition until you have spoken to your
insurance specialist or legal counsel.
In Florida, advanced practice providers are required to carry
a minimum of $250,000 per claim and $750,000 aggregate lim-
its of liability. “We recommend that all APP’s carry a minimum
of $1 million per claim and $3 million aggregate limits while

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20 September 2019 southfloridahospitalnews.com South Florida Hospital News