This week is another week of administration!! It is not my favorite part but I have to do this to pay the bills! As many know, we changed our system back in April. It is always difficult to do this and sometimes it catches up with us. There has also been another change as of October 1st with the new ICD10 coding system in that we can no longer use unspecified diagnosis codes when we have a better code. If we don’t do this Medicare won’t pay our claims. Often, we as practitioners, get far behind on notes due to so many undone tasks pulling on us daily. I also struggle with fatigue by the end of the day due to RA and medications that I sometimes have to take. CRNPs have to be trained to learn the new guidelines just as I have to be trained. It is my job to train them. It can be quite difficult for them as well as me. When I have to look at each note before sending it and many times I have to send them back to a CRNP for corrections and then look at it again I can get quite far behind as I am now. So this week I am working at home to complete as many notes as possible so we can pay the bills!! It takes 2 – 4 weeks and sometimes much longer to get paid by insurance companies. This means I cannot see patients this week which is my most favorite part of the job. So if you do not see me this week in clinic you can understand why. I have over 900 notes to complete for the last two months. I can do about 150 per day when I am not seeing patients. That is a good day! So you see how I must catch up. I work hard to help my nurse practitioners know how to code so my job will hopefully get much faster after these few weeks of training them. It is often very frustrating to them as well as myself to see a note more than once!! Other medical practitioners may not worry and fix notes as I do but in the long run it helps us be able to see patients for much longer visits. We are committed to giving patients as much time as they need when ever they come in to reduce the number of visits and co-pays as well as keep them as healthy as possible.