NP Launchpad
In this podcast, a dynamic trio of Fitzgerald Health's NP faculty members show you what works and what doesn’t in clinical settings and beyond. From logistical subjects like licensure, salary negotiation, and documentation to emotional topics like self-doubt and burnout, our hosts guide you through the complexities of practice.
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NP Launchpad
EP 19: Prior Authorization, Referrals & Denials
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Navigating the health insurance system can be tough, but NP Launchpad is here to break down the nuances of securing coverage for patients. In this episode, we dive into managing frustration, bolstering defenses for appeals, and creating the most comprehensive documentation for patient visits to get prior authorizations fast. Vanessa, Christopher, and Jason share tips and tricks for patient advocacy and call attention to the pitfalls of the appeals process. Tune in for special instruction on completing GLP-1 coverage applications using simple online tools.
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Welcome to NP Launchpad, presented by Fitzgerald Health Education Associates, the podcast created for newly graduated nurse practitioners navigating the transition from school to clinical practice. Hosts Jason Gleason, Christopher Gleason, and Vanessa Pomerico De Nino deliver real talk, real experiences, and practical guidance to help you succeed from day one. So if you're ready, let's jump right in.
Jason GleasonWelcome back, everyone, to another episode of NP Launchpad. This is Jason Gleason coming to you live on your podcast, and I am sitting here with my good friends, Christopher and Vanessa. Vanessa, how are you doing?
Vanessa PomaricoI'm good, thanks. How about yourself?
Jason GleasonGood. What was the best thing you did this week?
Vanessa PomaricoI had today off.
Jason GleasonWell, hey, that's great. That is nice. Very nice.
Vanessa PomaricoThat was that was a good thing. Yeah.
Christopher GleasonThat's a great thing. Christopher, how about you? I have to kind of go along with V. I had the afternoon off on Monday. Nice. Nice. What is with all this time off?
Jason GleasonGeez, that is living your best life, truly. So yeah. Welcome back, everyone. We are so delighted you're with us once again. And as I mentioned this again during the introduction of every podcast, we really respect your time and we appreciate you tuning in. You know, there's a way that you can connect with us. nplaunchpad at fhea.com. You can email us, send us your comments, whether you love the podcast, you hate the podcast. Please don't send in a lot of hate mail. We don't like that. But we don't want to do restraining orders against any of you. But uh but yeah, stay in touch with us as we build this community. Communication is so important. And NP Launchpad at FHEA is one way you can reach us. So quick disclaimer for this podcast and all of our others, we are here as your friends and colleagues. Your friends and colleagues, we're not offering you legal advice, clinical advice, or even administrative advice, right? We're your friends and colleagues giving you the nuts and bolts of practice from our viewpoint, our perspective, our experience over decades of NP work. And we're just thrilled to share all that with you and hope that you find it helpful. So in this podcast, you're gonna be delighted, delighted to know that we're gonna talk about the fun topics of prior authorization, referrals, and those stinking denials, right? And the appeals you got to do, and then the renewals on medications after you get an authorization, then that it comes up for renewal, you know, all the paperwork you have to do.
Christopher GleasonWe would have to look at your definition of fun.
Jason GleasonI'm just I know, it's a blast, right? That's why that's why I don't get a day off, right? Yeah. So but we're gonna look at all this. We're gonna give you some great tips that hopefully you'll you'll jot down and they'll be in the show notes for you. Great tips to get through this quagmire of paperwork and documentation, everything we have to submit. And this is gonna be a great, great discussion.
Christopher GleasonQuagmire, 10 cent word.
Jason GleasonI know, right? Absolutely.
Christopher GleasonGet out of here.
Jason GleasonGet out of here. All right. So as okay, so with every episode, we dive into hot topics, so let's get right into this. So why do prior authorizations and referrals feel like a maze? I'd say a freaking maze built by raccoons with clipboards, and how can we make I'm just imagining a raccoon with a clipboard running? Can you all see that? Yes, running around. Yep. So built by raccoons with clipboards, and how can we make the process smoother? Vanessa, what would you say?
Vanessa PomaricoI I feel like I sound like I'm repeating myself over and over again. But if you have concise documentation and you have the appropriate diagnosis code linked up that supports your data, the prior authorizations go much more smoothly. I will say that there are times when my medical assistant will call, give all of the information that they are taking right out of my note, and the insurance company will still say we need to do a peer-to-peer. So now I have to take time out, you know, or you know, with the 10 minutes that I get to use the restroom in the middle of the day, I'm on the phone doing a prior off, and I give them the exact same information. And then they go, Okay, here's your prior authorization number. And the last time I did this was just probably a week or two ago. And I said, Do you mind if I ask you a question? Because I don't want to shoot the messenger, it's not their problem. It's not their fault. I said, But uh, my medical assistant gave whoever they spoke to before you this exact same information, and you have a copy of my notes. So could you tell me why it was necessary for me to have to take time away from my patients to do prior authorization? And they said, Well, kind of skirted around a little bit. Well, you know, we have to just make sure that it is accurate information. All right, my medical assistant just gave you what was in the note, how much more accurate can it be?
Jason GleasonWow.
Vanessa PomaricoBut wow, you know, um, I will say that I do far less peer author peer-to-peer authorizations because I make sure that my note, if it's in the review of systems, it's addressed in the physical assessment, and it's addressed in the chief complaint as well as my plan. And you know, the insurance companies can't really argue with that when everything is documented and it's there.
Jason GleasonYou know what I love that you just said, Vanessa, is be kind to these people that we're talking to, right? And I'll tell you what the reality is this you call for for a prior authorization, press one for this option, and then press two, and then press three, and then you get disconnected, and you gotta start all over again. And you hear all these messages about vaccines and come into this place from that place and go here and there, and and all the irrelevant information you don't need. You just want to get to the person, and finally you get to them, and by that time you're just burnt, right? You're upset, you're frustrated, and it's so easy to kind of go off on them, even in your tone of voice. But I would say purposely sweeten the tone of your voice, right? Be super kind, almost kind on purpose in some ways, because you never want to make these people angry. They're not gonna retaliate against us, but it be nice to them, be kind to them. You'll be shocked at what information you get. You know, for the hot topic of obesity management and all these GLP ones out there that we're getting prior authorizations for. I found out some great information from the person I was asking for the prior authorization that I would have never had. And I'll share that later in the program. But be kind to these people, even though you're frustrated, take a deep breath, reset, and be kind on purpose.
Vanessa PomaricoThey're just doing their job.
Jason GleasonThey are. Oh, can you imagine working in the job that they have? They are saints. Yeah, hopefully they're getting paid big money.
Christopher GleasonSo um recently I was doing a uh prior authorization and I was talking with um with one of the uh sorry, take two. Recently I was doing a prior authorization and talking with uh one of the representatives, and they actually told me that when the case first goes to them, it actually doesn't go to a person. It goes through like an AI sort of system that screens everything. And if it doesn't match every single, you know, bullet point, then the that'll it'll automatically reject it and send you back. Right. Yeah.
Jason GleasonAnd I think we're gonna see more of that, don't you? Yeah.
Vanessa PomaricoAbsolutely. You know, listen, they're using AI, and they've been using scanners for um applications, job applications for years, and now they're using AI, and I I agree completely, we're gonna see a lot more of this. So again, if it's in the chief complaint, in the review of systems, in your physical assessment, and your diagnosis and plan, it's gonna be a lot easier, especially if AI is scanning the information.
Jason GleasonAbsolutely. You know, the other tip for our listeners, I would say, is talk with your team. Don't put all this on your shoulders, right? Many practices have a prior authorization specialist that works with a lot of these and they're they're experts at it. They do it all the time. Some clinics even have people do this all day long. Like a cardiologist's office has somebody doing prior authorizations for Rapatha, right? A $6,000 drug per year drug. And so they it makes sense for them to have somebody on their staff that this is your responsibility, because it's it's much better to utilize their time to do that than to utilize our time. We have other things to do. So if you have somebody in your office, but if you're out there and you work in a rural area and you're it, you're gonna be stuck at doing a lot of this. But if if that's not your situation, if it's different, ask your clinic and maybe even during a job interview, hey, who does your prior authorizations? What's the process for that? Our next hot topic, moving on to more fun, right? When a denial, oh, this one's a good one. This is gonna be so much fun. Trip to the carnival. When a denial lands in your inbox, we gotta love those. What documentation helps you fight back effectively without losing your mind? Christopher.
Christopher GleasonWell, actually, V's already touched on this. I mean, it's so important to go through your documentation. Make sure that your prior authorization contains all of the reasons that you need this medication, you know, and have it throughout your turning. It's so important, especially when they go to um to push the um prior through.
Jason GleasonOh, yeah. Anything to add to that, Vanessa?
Vanessa PomaricoYou know, just what Christopher said, you know, I always think about stress tests and trying to get a prior authorization for a stress test, and then I have to talk to somebody, and I and I'll say I'm not sure what criteria I'm missing here. I've got a 53-year-old female, post-menopausal female with atypical chest pain and a history of high blood pressure and high cholesterol. What more criteria do you need here?
Christopher GleasonRight, right. Oh, yeah.
Vanessa PomaricoAnd, you know, again, I think because, you know, it's just like when we were talking in another episode about billing and coding, you know, people make mistakes. And so somebody might not have picked up on that or they didn't read it, and that's why there was a denial there. So, you know, I would just say deep breaths, make sure that your documentation is clear and concise, and then just ask the question. So, getting an MRI, like a lumbar MRI, on a patient who's already completed six weeks of physical therapy, did the NSAIDs, did predatome, not getting any better. And and then I'll say to them, what more do you want? What more do you would you like me to do before I can get the MRI? And they'll say, Well, did you do an x-ray? And I said, An X-ray is not going to tell me anything different than what I've already done. And why am I going to radiate this patient unnecessarily? And they never can answer the question. They just go, okay, it's authorized.
Jason GleasonYou know why? Because it's in their binder. Yes, in the algorithm, right? Yeah, that they're reading to us drives me nuts.
Vanessa PomaricoSo it's an array to stand up.
Jason GleasonNo, no, and not fight back, but that's what you're really doing, right? You're standing up advocating for your patients. So one thing I've learned to do whenever I submit a prior authorization, and let's use the example of the hot topic of the day, the GLP1s, GLP1, GIP combo drugs out there that are super expensive that insurance companies are covering, but with prior authorization, right? And big copays. So using that as an example, but you can apply this to any kind of prior authorization. Number one, check out the insurance company's website because often for a lot of medications like the GLP1 and GLP1 GIP combos, they have a form for you to fill out, for you to fill out. And so I love tri I absolutely love TRICARES form for this because they're check boxes, super easy to fill out, and it's easy, like five minutes, right? So check with the insurance company's website themselves. And how do you do that? You would go to their website, and for medications, for example, they'll have a formulary, and then they'll have a box near that, usually that says prior authorization. You click on that and it takes you right to the form. You fill it out online. It's a PDF usually, you fax that in. So that's number one. Check with the insurance company, whoever you're asking for prior authorization from, and look at the website rather than call them up initially, because often the answer is on the internet, and then you don't have to stay on hold. Number two, I love what you said, Vanessa. And I I view prior authorizations as like if you're an attorney going to court, right? We're not attorneys, and this is not legal advice. But that's the frame of mind you have to have. How am I going to build the case? Why should this patient in front of me get these services that they need? Why should they get these services? You got to build the case and it has to be compelling in addition to all the boxes being checked off, right? And so one way I do that and organize all of this into one packet that makes it easy for our listeners out there, and it's been easy for my practice, and then you get less denials, and then you gotta resubmit more paperwork, it takes forever. So, number one, check out their website for forms, fill that out. Number two, even though you fill out the form, remember these people look through all these authorizations, you know, maybe 20 to 50 a day, right? They get burned out. They get burned out. And the easier that we can make their job, the better it's gonna be for everybody. So what I do is I fill out the form for prior authorization, and then I add a cover letter, a nice summary of what's on the form. Here's why the patient needs this. And use AI. Type into your AI at work. Patient has these health issues, write a compelling letter why they should get this drug authorized, and AI will spit it out for you. You know, that or come up with your own, some kind of cover letter to organize it, to make it so easy. So when they look at that fax that comes through, oh yeah, this patient has this, this, and this. I'm gonna confirm that on the form, we're good to go, right? And submit all of that in one fax to them. Usually it's faxing, faxing these things in. Submit all of that, and I've never had any big issues with denials where I got to submit more paperwork. The other thing that our audience members have to be aware of with these GLP1 and GIP drugs out there, and again, this is such a hot topic, you will be faced with this on a daily basis. Patients are beating down our doors wanting these medications because they're so effective. But yeah, prior authorization. That's one thing. Let's use an example. Sarah, you know, you're struggling with obesity, and these drugs are wonderful, and you go over all the risks and benefits. I'm going to prescribe this for you. Let's submit prior authorization. Okay, Sarah, we got your prior authorization approved from the insurance company. Great. Here's your prescription. Sarah goes to the pharmacy and they say, Yeah, here's your drug, and it'll be a $650 copay because it's a tier three. That's the reality. Sarah comes back to your practice, and she has struggled with obesity for decades. She's a weight loss expert because she knows everything she has to do. And these medications are finally the science is finally caught up. These medications are going to help her, but she cannot get the tools she needs. So is she discouraged and deflated and angry at us and upset? Absolutely, absolutely. So at the time you're submitting a prior authorization on these medications, especially, look at the uh insurance's website, look for a tier exception form. And it's a simple form to fill out, but actually, in most cases, all the information on the prior auth form is almost identical for the tier exception form. And the tier exception form you would think would be based on income and you know assistance programs. They're usually not. They're usually not. Like on the tier exception form for GLP1s and GIP through Blue Cross Blue Shield. Currently, there's not one question about finances and inability to pay for the medication. It's all the information that is on the prior authorization. So here's your deal. Number one, check out the website for any forms you got to fill out. Number two, write that cover letter. Number three, submit the cover letter, the form, and then a tier exception form in those cases where you need it. And lastly, our next and final hot topic for this episode: how do you talk with patients about delays, denials, and costs without sounding like the insurance company's voicemail menu? Vanessa. Yeah.
Vanessa PomaricoVanessa, you're I I tell the patients routinely when I'm when I'm uh you know prescribing a medication. You know, like you said, the patient you prescribe it, the patient goes to the pharmacy. You have we have no idea of knowing what the insurance is going to cover.
Jason GleasonNo.
unknownNo.
Vanessa PomaricoAnd so I always say to the patients, I'm prescribing an inhaler, and I use that a lot because one of the inhalers, you know, can cost $700. And I don't want patients paying $700 when there's something else, an alternative. So I always say to them is that, you know, insurance requires what we call step therapy. So I have to try them on this medication first before they'll cover anything that's a higher copay. So in the meantime, until I can get, let's say, your Symbacort authorized, I'm going to give you albuterol and adver to use until I can get, you know, the SIMBACOrd or something, or if we can get, you know, one of the patient assistant programs or whatever. But at least be able to have that plan and just say to the patient, this is just what it is. Most patients are pretty savvy these days that they do understand that a lot of the older medications are going to be a lesser copay and the newer designer medications are going to be a higher copay. Um, it's a little bit harder with our elders because they don't understand, like, what do you mean I'm gonna pay $700 for a prescription? Oh, yeah. You know, so I just tell them that we have to do step therapy. This is not my rule, this is an insurance rule. We'll do what we can to get it covered. And, you know, just communicate with me. If you get there and it's too expensive, just let me know. We'll find an alternative. And so I always try to keep it positive. And I also tell them, too, is that if they're uninsured or underinsured, there are $4 prescription co-prescription programs like Walmart or Target, you know, um, and some of the other online pharmacies where you can get good medications that are only $4 a month.
Jason GleasonYou know, another great resource that I just recently found out about is Costplusdrugs.com. And we don't have any connection to these places financially. None of us do, right? There's no conflict of interest for us, but they're just great tools for you out there listening. But CostPlusdrugs.com, MarkCubin's online pharmacy, it's a company. I just found out this week from our GYN specialist that estrogen cream, which is usually sky high in price, is like $15 from that website, Costplusdrugs.com. Vanessa, what are the resources, uh, websites, any programs out there that you'd recommend that providers need to know for their patients?
Vanessa PomaricoYou know, I think it's a matter of you know, looking at what your patient population's insurance is. So for example, I have a fair amount of Medicare Medicaid. In Connecticut, we have Husky. And so those programs are prohibited. The federally funded programs are prohibited from participating in any of the coupons, so the manufacturer coupons, that kind of thing. So I just make sure that the patients know where they can get more cost or you know, uh less cost prohibitive medications like Walmart Target, Cost Plus, Amazon Pharmacy, those kinds of things, just so that the patients have it at their fingertips.
Jason GleasonI love your idea about having one page of information, a handout to give your patients, Vanessa. I think I'm going to start implementing that in my practice with all these assistance websites and low-cost uh assistance programs that are out there. So yeah, I love that. Christopher, do you do anything like that in your practice?
Christopher GleasonWell, I don't have a sheet that I hand out to my patients. I will um look quickly on Good RX just to see what the price is with them. And again, I'm not affiliated with them. Um and if the if I can, I'll print out a coupon for them, you know, send them to the pharmacy with it and things like things like that. That's great.
Jason GleasonYou know, goodrx.com, that's another resource for those of you that are writing things down out there. I touched my face. Goodrx.com, for those of you writing things down out there, and also be in our show notes. And again, we have no connection to these. Goodrx.com is an excellent uh source for you. And then have you guys heard of myneedymeds.com? Myneedymeds.com.
Christopher GleasonNo.
Jason GleasonIt's been out there forever, but I love that one. You can type in any medication, and this is for assistance programs. You can type in any medication in their little search bar, it'll come up. And what I love about it is, because you know, doing the deep dive on all these pharmaceutical companies' websites is such a pain in the rear and it takes so much time to find the form you need. So needymeds.com does away with all that because they you type in your medication, up comes a link that'll take you directly to the pharmaceutical uh company's website, but beyond that, it takes you right to the form you need. Absolutely love it. That's for your prior authorizations, you know, based on financial need uh with your patients. So goodarx.com, myneedymeds.com, any other resources you want to share with our audience. I think that covers it for me, anyways. Yeah. UV?
Vanessa PomaricoI think that covers it.
Jason GleasonExcellent. And again, we have no connection to any of these companies or anything we mentioned during our program. All right, great hot topic discussion. We have some fantastic resources for you that we want to share with you, and this will be in your show notes. CMS Prior Authorization and Pre-Claim Review Initiatives. There's a website for that in the show notes if you need that information. CMS Electronic Prior Authorization Overview is also listed there. The AMA prior authorization practice resource is a great guide and delivers some excellent information for you. So check those resources out in addition to the other ones that we shared with you during this episode. Fact or fiction, it is time, right? Test your brilliance. And Christopher, I have to say during the last episode, those questions are pretty easy. I'm curious what you're gonna think of these ones. All right, you ready?
Christopher GleasonI had to level them out for you. I'll listen to you. Listen to you, huh?
Jason GleasonEnd of show right now. Gosh. All right, Christopher, you're up. Good documentation can increase the success rate of prior authorizations.
Christopher GleasonAbsolutely fact. And you know, we we've kind of beat that beat that dead horse throughout the uh throughout the program. And Vanessa did a great job with presenting it earlier. Thank you.
Jason GleasonAbsolutely. One piece to that I think it's important to note is never ever document falsehoods, right? You don't want to commit fraud. Because it might be even tempting in some cases. Oh, if I just fudge this number or fudge their BMI or something like this, they will audit you and that could result in big fines or even jail time. So never ever commit fraud. Don't do that. All right, Vanessa, an appeal letter should focus on clinical rationale and guidelines support.
Vanessa PomaricoI'd say fact on that. It's only going to support your diagnosis and why they they need to uh approve it.
Jason GleasonAbsolutely. Absolutely. You know, a good example in my practice where this was relevant at one time, we know that for cluster headaches, oxygen therapy works wonders, right? Works wonders. But it's so hard to get approved, you know, through insurance companies because they're used to like a respiratory condition, a pulmonary condition where you need oxygen. So I'll write on the prescription, you know, the the um the oxygen therapy for cluster Cluster headache and the the regimen that you would do, and that's beyond this episode, but write it on a script. But then you know what I started doing where I get approvals so easy now? I actually submit a copy of the study that shows that it's helpful, right? Yeah, it's amazing. I've never had them deny it because here's the proof, here's the evidence. So again, build the case, pull out all the stops to build the case. All right, Christopher, patients appreciate clear scripts about what happens next.
Christopher GleasonAbsolutely. We talked about you know we talked about that with price, we talked about that with just you know general plan of care.
Jason GleasonExcellent, excellent. All right, moving on over to a very important announcement for all of you out there who doesn't love discounts and saving money. We appreciate all of our listeners, and we'd like every single one of you out there to get a special discount. So if you order anything as far as CE or memberships go on FHEA.com, and if you enter the discount code launchpad20, you get a 20% off all CEN memberships. Again, that word is LaunchPad 20. All one word, launchpad 20. Write that down and utilize it and save 20%. Who doesn't like to save money? Moving on over to our mailbag, and the way you connect with us again is nplaunchpad at FHEA.com. Keep sending those questions in to us. We love answering them, and it really sparks some amazing and intellectual discussions. So, first question up: what prior authorization or denial is currently driving you up the wall, driving you absolutely bananas, and how do you get around that? Vanessa?
Vanessa PomaricoOkay, all of them drive me up the wall. Um I have to say it's the medications. Like you said earlier, you have a patient who's been obese their whole life. They are a you know an expert in diet, and they fit all the criteria for getting, you know, a GLP one or one of the other medications. And and we get an insurance denial. And and again, I always say when I have to do the peer-to-peer, what more information do you need? Because I put the onus back on them to say, all right, I've done my part, help me here. Like, what do I need to do here? And again, killing them with kindness because it's not their fault that they have a job that makes the rest of us go crazy. So if you you know, if you don't know what you're not doing, you know what you're doing wrong, just ask them what do I need to support this so I can get this prior authorization?
Jason GleasonAbsolutely. Good points. I I think their job would be very similar to those at the DMV. Exactly. While you're waiting forever. And it's not their fault, but we get irritable. So be kind on purpose, remember that. Christopher, what do you say to patients when a medication or procedure gets denied or delayed? What do you say in real life to them? Give us an example of a situation you had recently.
Christopher GleasonYou kind of have to you know what what V said earlier, that kind of approach, you know, approach them with kindness, approach them with an understanding, but help them to understand why it was denied. I think that's I think that is so important. And if you're doing that step approach like Vanessa was talking about earlier, you know, you have that th those um medications at first that you have to try and you know meet those meet those bullet points. But make sure that they know that and say, hey, you know, we have to try these medications first. It's not necessarily a full denial, but we still have to follow the steps in order for the insurance company to pay for them.
Jason GleasonDo you have any examples recently in real life you could share?
Christopher GleasonActually, I do. So um I have a patient at the VA that um when they came to the VA, they were on Manjaro. Manjaro is one of the GLP ones that's not necessarily covered by the VA initially. And yeah, exactly, and they have to meet certain criteria to get on to receive it. So, but there there was a step approach to actually you know say, hey, they've tried this medication um or they need to try this medication to get to the Monjaro. So we did that. We, you know, we I prescribed the medication that they needed. We we did the trial of the medication, they failed the trial of the medication, so and eventually the Manjaro was approved.
Jason GleasonExcellent, excellent. Good examples. And you'll run into this issue every single day. So be ready for it. Be ready for it. All right, your wrap-up landing checklist, things to consider as we uh get through this episode and wrap up. Save payer criteria PDFs. Again, as I mentioned, as I mentioned, in a systematic approach when you're submitting this prior authorization information, cover letter, right? And that checklist, save payer, criteria, PDFs. We're talking about the checklist or the PDFs that your insurance companies want you to submit based on what you're asking for authorization to get. So, number one, check out the website, check out their website for these forms, these PDF files, fill them out, attach a cover letter, a nice summary, make their job easy for this prior authorization to go through, right? If it's necessary, also submit the tier exception form with them, especially for those GLP1 and GIPs. I mentioned again, they're they're catching on that we're we're submitting the tier exception, and there's no fraud here. We're just using the tools they want us to use. But they're catching on to that. And so I've seen some coming back as denied. We we no longer honor tier exceptions, but you can at least try. You can at least try. So another key thing is to create a prior authorization note skeleton. Heck yes, right? That's your cover letter. Create a template so you don't have to reinvent the wheel every single time. And then write the why in your note. Write the why. Why does this patient need this treatment or this medication? Build the case, build the case. So your homework for this week is I want you to type up a sample of a template for prior authorization for medication. Work on that, and then you can adjust it down the road as needed. So to close up our episode, was this fun, by the way? I promised you it'd be fun. Okay. These are fun topics, right? Yeah, absolutely.
Vanessa PomaricoHard topics, but necessary.
Jason GleasonI think our next episode is going to focus on colonoscopy and toenail removal. Which could be this one, right? I don't think so. We don't want to see those. Certain things we don't want to see. Toenails, I would, but yeah. So to close up here, thanks everyone for tuning into our podcast. We absolutely love all of you and our interactions. Keep sending us your comments, anything you like about the program, anything you think that we should work on. And we and we so much appreciate you and your time. We really respect your time and hope that you find this worthy of your time and that it's useful to you. I'd ask that you also drop five stars for our podcast. What that does in the podcast world, it bumps us up in visibility, which doesn't mean a whole lot to us except that we're gonna build a bigger community, that we're gonna help more people out there, more NPs, more nurses that are gonna become an NP. Nurse practitioners are gonna switch from one specialty to the next. We're gonna help more people as we build our community because we help each other, because we help each other. And then hit follow because you don't want to miss a thing and tap subscribe. Tap subscribe. And most importantly, most importantly, please share this podcast with your friends, your colleagues, whether they're NPs, nurses, physicians, whoever they are, share this podcast with them and ask them to tune in because as we build our community, each of us are going to be built stronger to take great care of our patients. So thank you for tuning in, everybody. Catch you at the next episode. Have a good week, y'all.
Christopher GleasonBye, everyone. You've been listening to NP Launchpad, presented by Fitzgerald Health Education Associates. Like, subscribe, and share. And for more tools to power your NP career, visit FHEA.com.
