After the PMHNP Boards

Policy & Career Help

Credentialing? What to do After Passing Your (Psych) Boards??

Congrats!!! If you were like me and so fixated with passing your boards that you forgot everything your advisor told you then you’re not alone! When I passed and finally came to my senses, I just fumbled around like now what?? If you already have a job pending or a great helper, please be very happy because some people are simply not in that boat. I had nothing line up and was hoping to leave town before the pandemic threw everything off.

Thankfully, I was already beginning my telepsych job and they were truly awesome with my credentialing process and hope to share some information for those who need help. Granted healthcare is constantly changing but I’ll try to keep the major updates right HERE for credentialing psych NPs only -I can’t speak on other APRNs but hopefully, it’s not that much different. Here’s a general guide (no particular order but in the order, I went in) for the NP billing/provider process:

  • Notify your school: graduate programs try to keep track of graduation and passing rates for accreditation but it’s not mandatory to notify *if you’ve passed. I did this to make sure my school remained accredited aka I don’t need more stress!
  • Call American Nurses Credentialing Center (ANCC) to notify your state of practice: ANCC does not communicate with your state or it may take a while to update information. Calling was a simple 10 min phone call to expedite the process of credentialing.
  • Go online to get your RN license upgraded to an NP (~$40): Again the state does not communicate with the boards so you have to go online to change the status. Call the state if the website is confusing or unable to find the process.
  • Apply for your NPI/CMS (Centers for Medicare & Medicaid Services) (free): if you ever worked in a community mental health/nonprofit, you probably already have a number, if not it’s straightforward and generally hassle-free to obtain one. The National Provider Identifier or NPI is a unique identification number to cover health care providers and improve the electronic transmission of health information. This permanent number is also considered your CMS number.
  • Obtain a Medicaid & Medicare (Part A/B)/Medicare Provider Enrollment, Chain, and Ownership System (PECOS) profile: if not/unsure call the respected agencies (PECOS or your state Medicaid services). They do not communicate with each other and for my facility, I had to provide access -the username and passcode for PECOS, Medicaid, & CAQH.
  • Apply for your DEA license (~$800+): must renew every 3 years. Some facilities may pay for this, always at least ask or make it a tax write-off. It takes about 2-3 weeks to get the license.
  • Obtain a secondary State Controlled Substance License ($varies): I didn’t obtain this license, but it may be important if you’re working in substance abuse or research. These are the states that REQUIRE a 2nd CS License but I think it’s mandatory for physicians. Double-check with your local DEA.
  • Start the CAQH Online Resume/Online Portfolio (free): This information is primarily for servicing Medicare/Medicaid patients. Your employer will fill out the respected areas so you just need to give them access/your password but you must fill out the other 98% of the portfolio. Also, this is the place where you have to post your malpractice insurance and all your other credentialing information i.e. DEA number, NPI, school/work information…etc. that’s required for the attest approval. You have to keep the information updated/attest every couple of months. Also, if you leave a job, make sure you know the password and change it to keep your information secured.

While the employer is either working on the credentialing or waiting for the insurance companies to approve your status, it may become a waiting game or the biggest delay. This process can take up to >4 months if you are completely new to the process (1st time as an NP) or as little as 3 months if you’re already actively approved with insurance companies.

Health services have to be billable, therefore you may not be able to function as a provider until this process is completed or you can start and get billed under a physician. If you’re doing everything on your own, then I would recommend calling government/insurance agencies and maybe they can guide the process since that’s the biggest holdup…

Also, this whole ordeal is assuming that you have a clean license, no felonies, foreign issues, or other critical situations that can affect the process. Do not take it personally, everything in CMS or things related to healthcare works like it’s on island time. It feels like and takes FOREVER. In the meantime, you can pick up more work hours, enjoy some free time, or work on additional requirements:

  • Obtain your Medication-Assisted Treatment (MAT) waiver or do the training hours (free): the course provided by APNA is a 24-hour course divided into 8 hours (1st course) and 16 hours (the second course). When you apply for the waiver, your state may require a collaborative physician, which you may not be able to get the waiver at the time but you can still do the training so when you do find the physician, you can easily apply. The hours/test isn’t bad just time-consuming.
  • Get Clozapine Risk Evaluation and Mitigation Strategy (REMS) access (free): the requirement to prescribe, dispense, and receive clozapine that is shared into a single program called the REMS, which is mandatory if you prescribe clozapine. This process is not as long as the MAT’s waiver but the website and verification were tedious, I had to call them.
  • Register to the Prescription Drug Monitoring Program (PDMP): a tool used by prescribers and dispensers to assess patient risk of drug abuse and is also used to prevent diversion at the prescriber, pharmacy, and patient levels. I’ve gained access within a day and it’s not required with some jobs or in every state, but this is important and regulated if you are prescribing controlled substances. More Information

You can also start getting involved with organizations:

  • Neuroscience Education Institute (NEI): this little gem has so much information and helps with psychopharmacology. Membership is expensive but I did find a discount code on FB. NEI was founded by psychiatrist Dr. Stahl, so the content is similar to his books, nice and fun.
  • The Carlat Reports: provides clinicians with practical and engaging psychiatric education that’s not influenced by a particular doctor and gives the latest up-to-date information about mental health practices. Also, independent of pharmaceuticals and a great resource for psych medications is Psychopharmacology Institute.
  • Lookup/Join your local state NP Chapter or Find More Organizations/Resources

Don’t Stop Looking at the Job Marketđź‘€

As mentioned before in life, don’t put ALL your eggs in one basket. You can still find something supplemental, contract, temporary…etc. and explore many great opportunities, so you can expand your network/skills, become more marketable, and possibly command more money. Therefore, constantly keep your resume and CV updated. My top 3 favorite job sites are Indeed, Glassdoor, & ZipRecruiter, primarily because they all have an app, which makes it easy and quick to find other opportunities.

Mental health providers and Psych NPs will always be desirable! Don’t feel rushed or desperate to please one employer or compromise to the point of being miserable/unsafe. If someone doesn’t appreciate your service or presence, it’s their loss because YOU will always have options or at least keep them near…

Your Folder

Lastly, you want to get in the habit of keeping a hard copy of the information for the job and at home. This is due to constantly being asked about this information (for credentialing) or if the state decides to randomly swing by the office. The content of my folder (and/or on my computer) include copies of:

  • An Updated Resume
  • PMHNP/ANCC Board Certification & Nursing License (you cannot have your RN license lapse but your new license should include the updated specialty)
  • My College & Grad Diploma +/- Transcript (you can have your school email the transcript)
  • BLS and ACLS Certification (not always necessary)
  • DEA License
  • Malpractice Insurance: I went with the cheapest, Berxi– but it also specializes in telemedicine.
  • MISC Information: a list of references, membership cards…etc.

Hopefully, all this was useful. I also recommend schools/professors/advisors to print this off, tailor it, or whatever to go over this with NP students. It can be drastically different in other states. Anywho, keep doing a great job NPs!

Read about PMHNP Boards & Info

after passing the pmhnp boards


Additional Information

…What to Do After Passing [Other] NP Board Exams

After hours of planning, studying, and test-taking, when you finish your nurse practitioner certification exam, it will be time for the moment of truth. When your test is complete, your results instantly appear on the screen and you’ll know right away whether you have passed. Once you pass, take a moment to celebrate your accomplishment and hard work!

Your certification will be good for 5 years. (Details on how to maintain and renew certification are available on the American Association of Nurse Practitioners (AANP) and ANCC sites.)

Of course, after taking your test, there are still a few more things left to do before you are officially ready to practice.

What You Receive After Passing Your NP Exam
After passing the ANCC exam: You will receive a copy of your results before you leave the testing center. Within 2 months, you’ll receive a certificate and pin to celebrate your achievement. ANCC does not automatically send verification of certification to your state board of nursing or employer, so you will need to request this be sent to the proper location(s).

After passing the AANP exam: If all required documentation is on a file, a printable wallet card will be available for download online within 48 hours and an official score report and certificate will be mailed to you within 2-3 weeks.

If You Do Not Pass on Your First Try
If you do not pass on your first attempt, contact your university or Career Services team to see whether they have access to or recommendations for additional review materials to prepare for retesting. For the AANP:

You will first need to wait to receive your exam results in the mail. These results will show your strengths and weaknesses, and you must complete a minimum of 15 hours of continuing education in your weakest areas. You can typically obtain these through:

  • Attending a review course
  • Shadowing in a doctor’s office
  • Completing modules provided by the AANP
  • After completing these hours, you may apply to retake the exam. Two testing attempts are allowed per calendar year.

For the ANCC:
If you do not pass the ANCC, your score report will include diagnostic information for each content area of the test and you may retest after 60 days. You can test up to 3 times in any 12-month period. Wait 5 days after your first test to apply for a retest online.

What to Do After Passing Your NP Exam
Notify your university
If you’ve been working with your Career Services team or university to prepare for the boards, let them know that you passed. Complete the steps required by your state Board of Nursing and confirm what you need to do to receive your state license. Most Board of Nursing (BON) websites provide a checklist for this process. This process may include:

  • Requesting official transcripts be sent to the BON
  • Filling out your state’s BON application
  • Requesting that your University or Program Director complete additional forms
  • Initiating fingerprints and a background check. Additional processes and applications may be required by your state.

Send official transcript copies to your house
Although this is not required, we suggest you keep some official transcripts at your house for any additional paperwork that may be needed in your state or for future positions. If you request copies, do not open them upon arrival—doing so ruins the validity of the transcript.

Apply for your NPI number
A national provider identifier (NPI) is a unique ten-digit number required by HIPAA and The Centers for Medicare and Medicaid Services for covered US healthcare providers. It helps to track and transmit standard HIPAA electronic transactions, such as electronic claims and claim status inquiries. Not having an NPI number can hinder you when applying for jobs and may hurt your chances at a position.

Consider malpractice insurance
Look into purchasing your own malpractice insurance. Some employers will provide you with this insurance, while others require you to find this on your own.

Apply or register for prescriptive authority (if required)
Some states require you to complete an additional application for prescriptive authority. A few states also require this application to be completed by the university program director.

Apply for a DEA number
A DEA number is an identifying number that the US Drug Enforcement Administration (DEA) assigns to health care providers that allows you to distribute and prescribe controlled substances. This cost can be hefty (over $700), but employers often want you to have this prior to hiring you.

Apply to become a Medicare/Medicaid provider
This ensures that you can provide care to those covered by Medicare/Medicaid. Visit The Centers for Medicare and Medicaid Services website to get started.

South University

Also, check out:

  • Health & Wellness: Steps to be an NP via ANCC or AANP. (Only ANCC offers PMHNP certification)

Some Extra Notes/Updates 

  • I had recently updated my NPI title on the NPPES website, for some reason it still said RN so I had issues prescribing medications. I called because the password expired so also make sure your email is current in the system to get notifications. Everything was changed with just an easy phone call. Also, make sure the address listed is not your HOME address. The information is public and pharmacies need a (work) address to process prescriptions.
  • E-prescribing is heaven but scheduled medications or at least stimulants still have to be written out and picked up. They can’t be e-filed or my job’s system doesn’t do it, so knowing how to write out a prescription is still necessary. It’s straightforward once you learn it, this website was helpful, 7 Steps to Writing a Prescription. 
  • It was painful to deal with the process of getting the buprenorphine waiver. No one else had an issue at my clinic so I’m not sure what went wrong…Make sure you register or change your DEA to prescribed at ALL levels of medications to get the approval letter from SAMHSA and only then will the DEA will give you a new DEA number with the X included. I just assumed it was all automatic. The DEA does not communicate/connect with SAMHSA so if there are any issues you may have to contact both agencies: SAMHSA 866-BUP-CSAT (866-287-2728) and the DEA 1-800-882-9539. It normally shouldn’t take more than 3 weeks if everything goes as planned.
  • My colleague got me to sign up for a Doximity account to look at this article. It’s free and awesome. So if you don’t have a “company phone” and need to call a pharmacy or families, do telemedicine…etc. Doximity is like WhatsApp for providers. Your name is automatically in the system and when you sign up for it, you get a number so you can use the app to make phone/video calls. You do need to have Wifi and get limited calls *it used to be unlimited before recent changes…but it’s still super convenient. Doxy.me may do the same thing but I didn’t see it. UPDATE: Doximity changed to a free trial/subscription app only, but it’s not letting me upgrade or I’m not sure how to. I went back to *67 to make private calls but it’s still helpful for telehealth services, etc. I’m not sure of the costs but it should be a tax write-off to save $…
  • Keep receipts to possibly get a tax-deductible or to get reimbursed by the job. I still plan on doing a financial post but you can write off many things, especially in telehealth or your job may request them for reimbursements…

Keeping Track of My Reflections as a PMHNP 

Last Updated 7/2022

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