NP reimbursement and financial analysis in primary care

This project evaluates your ability to analyze NP reimbursement, credentialing requirements, and financial performance metrics. You will calculate RVUs, payer mix, and cost-per-visit for an NP-led practice, demonstrating your financial literacy for safe and sustainable practice. For this assignment, you will apply a payer mix of your choosing (e.g., Medicare, Medicaid, commercial). Your selected mix should be realistic for an NP-led primary care practice and must total 100%. Use your mix consistently in your calculations and interpretation. You will use this Module 4 Weekly Practice Dataset Download Module 4 Weekly Practice Dataset to complete your calculations. Use this Module_4_Reimbursement_Calculation_Worksheet Revised 2026.docx Download Module_4_Reimbursement_Calculation_Worksheet Revised 2026.docx to organize your RVU, revenue, and payer mix calculations. You may include the worksheet in an appendix AFTER your paper, or, embed your completed worksheet tables into your paper. Part A Credentialing Analysis Using course readings and Buppert Ch. 9 + Appendix 9-A: Identify credentialing requirements for: Medicare Medicaid One commercial payer of your choice Explain why credentialing matters for: Compliance Billing integrity Timely reimbursement Part B Reimbursement & RVU Calculations Using the Module 4 Practice Dataset (weekly visit volume) provided in the module: Calculate: Total RVUs generated in one week Gross revenue Cost-per-visit Adjusted reimbursement after payer mix adjustment Interpret Your Findings: What contributes most to revenue? How do payer mix variations affect sustainability? Which visit type yields the highest value? Part C Operational Recommendations Provide three evidence-based strategies to strengthen the financial health of an NP-led primary care practice. Formatting Requirements 34 pages (body of paper; not including title page and references, which are also needed. A running head is not needed). Tables allowed APA 7 Minimum of 3 scholarly or regulatory sources Aligned Module LOs Explain NP reimbursement models Calculate RVUs and payer mix impacts Analyze credentialing requirements Interpret financial data for practice decision-making Aligned Course Outcomes: CO 1, 5, 6