The Business of The CNA Instructor's Secret Cocktail

Summary:

On this episode of we have our FIRST return guest!

Victoria went from having a brick and mortar CNA school to leveraging her expertise into an online business where she consults with professionals who want to open up a CNA school.

Victoria Randle Is a Family Nurse Practitioner by trade, She started a business called the CNA instructor Consultants, also known as the Secret Cocktail. And helped individuals and organizations alike, start a nurse aide training programs in all 50 States.  She left her six-figure paying job, she wants to start touching lives and helping people and introducing them to the world of health care. 

"We had a heart to educate. We have a heart to help. " 

- Victoria Randle

Topics Covered:

1:55 -   Victoria Introduces herself, as a Family Nurse practitioner, and introduce her business.

2:42-  Sharing her down points when she started her business.

5:19 - Explains why she left her six-figure job, why did she choose to touch lives, helped people and introduced them to the world of Health Care.

7: 35 - Shares the patterns among winners, among people who seem to do very well with her program.

Main Takeaways and Quotes:

“I help nurses become entrepreneurs and I help them educate, you know, individuals to go out and then help others who need assistance.” 

- Victoria Randle

“Like somewhere along the way they end up losing that passion and losing that desire, It's like just remembering their why and having that passion and remembering why they have that passion.”  - Victoria Randle

“Sometimes, you know, I may come in contact with clients, like I said, who just, they have the drive but they're losing it. And me constantly like pouring into that and try and say to reignite that, but not always achieving. So that can sometimes be a challenge within itself because you have to learn when to let go”  - Victoria Randle

You know, if you want to skip the trial and error and skip the figuring it out stage, you know, they should definitely look into your program if they feel as though their time is more valuable.  

- Amelia

Connect with Victoria Randle:

• Instagram

• Website

• YouTube

• Facebook

To connect with Amelia:

• LinkedIn

• Email

• Facebook

• Facebook

• Instagram

The Business of Providing Medicare Solutions with Nurse Meredith Ximines-Mullings

What is your company name?

Nurse Agent X

What problem does your company solve?

My company promotes improved access and affordability to healthcare by educating and advocating for patients/families to be proactively engaged in understanding their health coverage. It is important that patients understand all the potential savings and costs for effective financial planning. This is achieved by collaborating with beneficiaries and walking through the projected expenses for a plan year and estimating their potential plan usage (this is where prior nursing and case management experience becomes crucial). Patients and their families can benefit from enrolling into a Medicare Advantage plan because there is a built-in financial protector which sets limits on healthcare costs during the plan year.

When did you first see this problem as one that needed to be solved?

Having worked as an emergency room nurse for over 10 years in several states, I have cared for patients who decided to sign out against medical advice because of the crippling fear of medical expenses. I have also cared for patients with multiple repeated admissions because of failure to afford the prescribed medication or failure to seek appropriate follow-up. Later, I transitioned into Case Management and the problems were even more forthcoming. It was evident that most patients were not aware of available resources/services in the community and how to employ cost control medical planning. It is imperative that patients understand their healthcare coverage and be able to anticipate the costs associated at each point of service. The use of an emergency room for non-emergent conditions is a common pitfall. These patients are incurring high costs when the same care could have been provided at a more appropriate facility, such as Urgent Care Centers or Primary Care Providers. 
 

Did the problem ever seem like it was bigger than you?

The problem did seem insurmountable at first because there are many variables when discussing healthcare coverage. Some of the major variables include age groups, employment status and state-based medical coverage (Medicaid) and Point-of-Service. It would be imperative that all insurance companies develop a campaign to educate and engage their beneficiaries in using their coverage appropriately. Medicare, on the other hand, has very strict guidelines and is better regulated than employee health insurance. The population (beneficiaries) is defined and commercial insurance companies have to provide the same basic coverage as Original Medicare, making it easier to highlight the benefits of choosing a Medicare Advantage Plan.
 

What makes YOU stand out from others who may solve similar problems?

There are thousands of Medicare Solution Agents today who continue to do an awesome job in assisting beneficiaries in selecting their plans. My unique contribution is my Nursing and Care Management experience. I have cared for these beneficiaries as a frontline nurse and I have first-hand experience of the numerous challenges they face, especially when trying to navigate healthcare. This population is often faced with multiple chronic medical conditions. I am able to use my nursing knowledge of disease conditions and processes to guide their health planning. For example, a patient with Type 1 diabetes can expect to be prescribed insulin (which can be associated with a high cost), and will most likely have orders for blood tests such A1C checks (will need to consider outpatient laboratory visits, transportation, etc.). I am also able to advise beneficiaries how to anticipate services such as podiatry (for possible peripheral neuropathy), nutritional consults (for glycemic management) and other key areas which are important in comprehensively managing their conditions. I also maintain community resources for caregiver services, support groups, etc. All these are available at no cost to my clients. They really get the best of both worlds.

What, if any, concerns are there related to nurses NOT knowing about non-traditional roles?

Truth be told, most healthcare professionals are unaware of how insurance works. I have been asked multiple insurance-related questions by patients. As a nurse, my answer would be…."I don’t take care of that part" or "I can get a representative from billing to talk with you" or "Let’s focus on your health now and worry about the bill later." My answers were not just generic to avoid answering the questions; as a matter of fact, that was all I knew, and it was often the jargons my colleagues used as well.

If nurses are not aware of healthcare costs and coverage, we cannot advocate for patients, we cannot educate or even guide patients in planning for these expenses. Let’s look at this example: If a patient (35 years old) states he will lose his Medicaid coverage at the end of the month, what would be a follow-up question for the nurse? In the past, I wouldn’t know the significance of such info, I would probably be screaming ‘TMI’ in my head or simply wondering why he thinks his nurse needs to know this information.

However, now I am able to interpret that same statement as implying: He previously qualified because of a disability longer than 24 months, he was diagnosed with kidney disease and cleared after getting a transplanted kidney, or he has returned to work and no longer qualifies based on his income level. 

An appropriate follow-up question would be:  "What if anything, changed based on your prior qualifying situation, or have you started the application for another insurance plan or will you be paying out of pocket for follow-up, will you need to change PCP, etc.?" These are all pertinent questions that will determine if this patient will transition appropriately in the community or returned to the acute setting because of failed outpatient management.
 

Some say, "It's not what you know, it's about who you know." In terms of developing business relationships, do you agree with that statement? Please explain your rationale.

I totally agree with that statement. You can have the best product but if you cannot get in front of the right clientele, your product will remain just a product. Likewise, in developing business relationships, it is important that you are known by the right person(s) who are influential in getting your name and product out there. Networking becomes imperative if you are going to grow your brand and build substantial relationships.
 

Tell us about your transition. What was the process of moving away from the clinical role into a business role? What mindset shifts, if any, did you need to make?

A key part of the transition was to seek knowledge about insurance. I enrolled in an insurance training program and for the first couple weeks, I was reminded how clueless I was about the financial aspect of healthcare. As my illiteracy decline, my interest grew tremendously. I passed the state examination and got licensed. Now I was really destined to make a difference…or so I thought. I approached a few individuals with my new-found knowledge; many were receptive, but very reluctant to change anything. Now the question was, do I just continue working as a nurse, watching people sink deeper in medical debt? As a Case Manager, do I continue to help a few needy families with the declining limited resources available? Do I continue to put the best interest of the hospital’s profit first, or do I help individuals and their families make more informed health decisions? I decided on the latter, but could not find the job description to match my desires. By this time, my mindset had begun the shift from a clinical role into a business role, which was often overshadowed by fear of the unknown and inexperience. Occasionally, I stop to question if I made the right decision but remain committed to the journey into entrepreneurship. On difficult days, I remind myself that I will always be a nurse and I can always fall back to the bedside - only in case of an emergency. That said, my transition is still ongoing; I still maintain per diem status as a Case Manager.

What has been the hardest thing in starting in your specific type of business or job role?

The most challenging aspect of providing Medicare solutions is obtaining your book of business. Pursuing prospective clients, gaining their trust while remaining compliant with the Centers for Medicaid and Medicare Services (CMS) guidelines can seem insurmountable. However, with patience, persistent and determination, most obstacles can be overcome.

What has been the most rewarding thing about being in your business or job role?

The most rewarding aspect of my job is the appreciation expressed when a client enrolls in a plan that offers them the freedom and choice to seek the help they need. When the beneficiaries understand their benefits, it is easier to coordinate their care, which will lead to less hassle and frustration when trying to navigate the complicated healthcare system.

What would you say are the five important resources (books, conferences, associations) for a nurse who wants explore business?

"M.O.B.E website, networking with nurse entrepreneurs, e.g.: BNE, Marquis, B.L., & Huston, C. J. (2015). Leadership roles and management functions in nursing:  Theory and application (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins, The Leadership Motivation Assessment found at
http://www.mindtools.com/pages/article/newLDR_01.htm"

Let's talk legal stuff. Many nurses are afraid of this part of business. How did you address this concern in your business? What worked for you?

I am also afraid of the legal stuff!  Outsourcing such services to the pros has saved time and headaches. 

Who supported you during this transition? Did you have paid mentorship or coaching? If so, what made you make that investment in paid support?

My husband has been and remains my greatest support during my transition. He contributes his time, knowledge, experience and also offers ‘unpaid’ coaching services. I am now able to appreciate the information learned in my post graduate studies, especially relating to marketing and finance. I also have a handful of close friends and relatives who are very instrumental in the process, especially by offering words of encouragement. I have ongoing mentors and support through the insurance companies that I represent. I have not located a nurse or healthcare provider that offers the same or similar services. I will continue to endure a lot of trial and errors (learning moments) which are time consuming but crucial for growth to occur. The importance of paid coaching in this area would be invaluable.
 

What would you like others to know about what you do?

Meredith is the founder of NurseAgentX.com, and offers Medicare solutions for eligible Medicare beneficiaries. She now offers transitional coaching for healthcare workers interested in getting started in insurance. Meredith believes that in order to improve access and affordability to healthcare, patients and healthcare providers must be proactively engaged in understanding healthcare coverage and reimbursement.  

Is there anything else you would like readers to know?

Starting a business is never easy. It's important that you are accountable and powerful to achieve your goals. Be true to yourself, follow your dreams, don't be afraid to fail and never give up trying.

Meredith Ximines-Mullings MSN, RN, CEN

Website + Social Media Handles :

nurseagentx.com, facebook: nurseagentx

In terms of marketing and generating revenue for your business, having the right conversations with the right person(s) is important. Targeted marketing strategies are recommended, hence quality over quantity will potentially generate the most wins.

#NPsLead with Dr. Irene Bean Nurse Practitioner

As someone who LOVES nurses and business, my sweet spot is nurses who want to grow their practice. While in a related Facebook group, I noticed Dr. Irene Bean and reached out for a quick chat. 

Dr. Bean is an American Association of Nurse Practitioner Fellow, Duke Johnson & Johnson Leadership Program Fellow, Founder of Tennessee Nurse Practitioner Association and CEO of Serenity Health Care, PC & Weight Loss Clinic. Our interview is below:

Please give us an overview of your nursing career

I'm a family nurse practitioner with 15 years experience. Prior to that, I was a registered nurse for 7 years. I now own a family practice in Madison, Tennessee and I'm also the founder for the Tennessee Nurse Practitioner Association.

What I do is advocate for patients, as well as nurse practitioners. My goal is to advocate for patients and to be aware of changes which may affect them. It’s extremely important for a practice or the leader of a practice to understand changes which are evolving for business owners and their medical facilities.

Recently I read an article from ModernHealthcare.com related to MACRA changes. It mentioned that nurses may not be as aware of certain changes as compared with physicians. The article can be found here.

What are your thoughts on the comment that nurse practitioners may not be as aware as physicians about changes that impact their practice? 

Personally, I despise that comment. I think practitioners are extremely aware of what’s going on around them. I have a problem with generalizing practitioners, because when you are a nurse practitioner or an owner of a practice, it is your obligation to understand all of the information that revolves around CMS, especially when accepting insurances.

If you are not aware of regulations that affect you as a provider, or unaware of your revenue, then your goals will not be as ambitious. Not all nurse practitioners are aware of changes and challenges, possibly because they are not included in decision making in some of the practices. For example, those who are employed by larger practices are provided limited information. However, it remains their responsibility to stay abreast of regulations that affect them as a provider.

There are companies which require practitioners to service 30-40 patients per day. CMS guidelines may not directly impact these practitioners because they are employed by larger companies. Many large companies do not disseminate much of the changes to the employees because they may feel that the information does not pertain to the staff. However, when employed by these companies, nurse practitioners are not “invited to the table.” They are usually the last to know, unless they are determined and independently research the changes.   

What do you think about the access we have to information now versus 4 or 5 years from now?

Information is readily available and accessible today, more so than 4 or 5 years ago. We have access to the internet, social media, and professional journals which may be as close as your smartphones. The informational highway is much more accessible and you do not have to leave home. But, if the provider is unwilling to research evidence-based practices, then, he/she is doing themselves and their patients a disservice.

There are so many avenues of information that are available for anyone. Google is every man’s best friend and can be for patients, too. Everyone googles everything. So if there's anything that you are concerned with or any information you feel you need to be a great provider, then the information is available for you. I agree that there are various ways to pursue information that is vital for your practice.

What are your top three sources of information that you look at every day or week to stay up to date?

My personal choice of information to review on a daily basis is the CMS website. This site identifies information pertaining to insurers, guidelines for billing and coding, MIPS, and chart audits. CMS has great resources.

The second source is the state Medicaid site. The state Medicaid reinforces what is on the CMS website; in addition to focusing on federal guidelines, there are areas that pertain only to Tennessee. The information is readily available for all who seek assistance from the state plan.

Another resource is the Blue Cross and Blue Shield site. BCBS has a large visibility in the state of TN. Many of their regulations mimic those of CMS and the TN Medicaid Program.  

The billing component of a practice is extremely important. Each of the resources listed gives a synopsis of what and how you should code. Each provides details about when it is appropriate to use the CPT codes 99211-99215.  

There are companies getting into healthcare that connect the piece between patient’s information at home with a clinical team to make decisions. What are your thoughts on payments for such solutions that would help the nurse practitioner in care coordination and where are payments for those solutions coming from now?

Home health care, concierge services, and telehealth are growing in the healthcare industry. These services allow healthcare professionals to reach patients who are in rural areas and cannot access quality health care. This is an advantage for both the patient and provider. The delivery of this type of care engages the provider with a community that may otherwise not receive healthcare. It is great that most insurances are reimbursing providers who offer this service for patients.  

For the past few years, the insurance companies are offering annual exams at the homes of the patients. These exams allow continuity of care for the patients who are noncompliant with medications and office visits, preventive services, and vaccinations.

The concierge services are widespread. These services will provide services wherever a patient prefers. The patient is responsible for the payments for these services.  

Do you see insurance companies paying for these monitoring system solutions or do you know practice owners who are paying directly?

Dr. Irene Bean, DNP, APRN, CME, FAANP, Duke Johnson andJohnson Fellow

No, I do not anticipate insurance companies paying for the monitoring systems, unless there is an available grant. There are companies that are providing applications (Apps) on smartphones and HIPAA-ready video connections. Larger telehealth companies are utilizing monitors and wireless devices to access patients in various communities.   

Tell us a little bit about your upcoming events.

The Tennessee Nurse Practitioner Association will host our 3rd Annual Statewide Conference on March 27-30, 2018 at the Omni Hotel, Nashville, TN. The keynote speaker for the conference is Dr. Margaret Fitzgerald. She is an author, entrepreneur, and has been instrumental for thousands of RNs and APRNs who have taken and passed their boards with her certification examinations and practice preparation. Also, Wendy Wright, who is a national speaker and has also prepared APRNs for certification, will be our guest speaker. Dr. Penny Jensen, DNP, advocated full scope of practice within the Veterans Administration. She is the former President for the American Association of Nurse Practitioners and continues to advocate on behalf of 243,000 APRNs. Dr. Dawn Vanderhoef, Director of Psychiatric Mental Health for Nurse Practitioners at Vanderbilt will provide a session on mental health; Dr. Tearsanee Davis, from Mississippi, will provide a session for telehealth;  Barbara Phillips will host a live workshop on how to “Start, Operate, and Grow Your Own Practice;” and a host of other guest lecturers will present.

If you’d like to attend the conference, please register at www.tnnpa.com. Students are also encouraged to attend for a great discount.

The Business of Product Design

Design Your Ideal Solution! 

Our guest on today’s podcast episode is Sarah Mott, founder of Nurse Born Products and inventor of the Koala-Qlip stethoscope holder. After carrying her stethoscope around her neck contributed to her neck pain and headaches, Sarah decided to look for a clip that would attach to her scrubs and carry her stethoscope. Through her research, she found that no such product was on the market, so she decided to pursue inventing one herself.  

Sarah has worked with many resourceful and innovative nurses, and she even carries some of their products on her website. Her advice to anyone looking to manufacture their invention is to first find a patent attorney to guide you through the process of creating a prototype, commissioning drawings of your product, and drafting non-disclosure agreements to be signed by anyone you deal with during the patenting process. Second, commit some time to touring manufacturing facilities to learn the “manufacturing lingo” and the ins and outs of the manufacturing process so that you are well-educated when it comes time to choose and sign a contract with a manufacturer.

To learn more about Nurse Born Products, follow them on Facebook, Twitter (@nurseborn), and Instagram (@nursebornproducts), and join Sarah’s Facebook group “Nurse’s Club for Business” to network with other nurses involved in business endeavors.

Business of Nursing Find Your Niche- Travel Nursing with Nurse Andrew Craig

One of the great things I love about the journey of being in business is meeting other healthcare professionals who are also business owners. When Andrew Craig came on my radar, I immediately reached out for a quick chat, and he said yes! What I love about his story is, while doing his thing and being awesome (personal branding 101), a company took notice of his awesomeness and reached out to him. Something similar has happened to me with Our Project Nightingale. In short, getting on the radar of a company is not that hard.

With that said, I want to introduce to you, Andrew Craig, travel nurse and YouTuber. PLUS, he is a co-founder with Adrianne Behning’s podcast,“Med Room Chronicles.” It’s an official, legit podcast! As I am super new to this world of audio, I'm a little intimidated by that! But I'm happy he joined me in this experiment with Anchor in September of 2017.

Listen to his interview below:

Our guest on this episode of the podcast is Andrew Craig, RN. Andrew and his wife, Sarah, have been working as travel nurses for the past two years, and they have now created their own company as independent contractors. Andrew has found success in creating video content to help and mentor other travel nurses as they consider or begin the profession, as it comes with its unique challenges and opportunities. He realized that he was ready to take the leap into creating this content because he envied people who were sharing their unique knowledge in this way on other topics--and he had his own experiences to help.

Andrew now has several sponsors of his video content, which is geared towards documenting the solutions that he has found to problems associated with being a travel nurse (or being someone who travels for work in general). The relationship with his sponsors is mutually beneficial for the sponsor, for Andrew, and for the listeners. Many people have reached out with positive feedback to his videos, which are paired with his Facebook group and will soon be associated with online courses. Additionally, he and two of his colleagues (Adrianne Behning and Brad McLaughlin) host the Med Room Chronicles: Nursing Uncensored podcast.

For more information about Andrew’s videos and online courses, follow him on Facebook, “Traveler Talk” Facebook Group, and Twitter; subscribe to his YouTube channel; listen to his podcast; and check for updates on his website and track the upcoming launch of www.howtobeatraveler.com.

Connect with Andrew  

His travel nurse group: https://www.facebook.com/groups/TravelerTalk

Linkedin: Linkedin.com/in/andrewcraigrn