Working with Inova Behavioral Health Services Advanced Practice Providers? Here’s What You Need to Know

Mary Fisher, DScN, APRNBC-FNP, LNP-CS/BH, JD, Interim APP Manager, Inova Behavioral Health Services, and Abigail Austill, PMHNP-BC, Behavioral Health APP Fellow, Inova Behavioral Health Services.

At Inova Behavioral Health Services, advanced practice providers (APPs) are a key part of the multidisciplinary behavioral healthcare services team – and patients benefit from their perspectives and expertise. Behavioral health APPs work across all domains and levels of behavioral healthcare at Inova including inpatient, outpatient and emergency care settings.

What are APPs? What is the APP’s role on my behavioral healthcare team?

Generally speaking, APPs are trained to diagnose and treat patients, helping patients get treated faster and offering enhanced personal attention. They are not physicians but can do many of the same things physicians do. They practice in collaboration with an overseeing physician and within a defined scope of practice. Behavioral health APPs coordinate with a physician if any patient needs fall outside that scope. With a behavioral health APP on the team, patients can expect high quality, multidisciplinary behavioral health care.

In behavioral health specifically, APPs diagnose and treat a range of mental health conditions. This includes taking patient histories, performing examinations, ordering diagnostic tests, prescribing medication, recommending appropriate treatments and providing follow-up care.

In Inova Behavioral Health Services, APPs are nurse practitioners and/or PAs. Behavioral health APPs bring a wraparound, holistic, bio-psycho-social-spiritual approach to the table, which is invaluable. They never lose the caring, holistic approach that they learned as nurses, which means they have a rich, multidimensional perspective to bring to patient care. Having an APP on the team means you have a second set of eyes on your condition and treatment plan, creating a cohesive diagnostic and treatment process.

In the inpatient setting, your behavioral health APP is often your primary provider, responsible for coordinating the bulk of your care. While you may not see a physician every day, you will see your behavioral health APP every day. Behavioral health APPs can be your primary provider in the outpatient setting as well, reducing wait times and getting you in to see a provider more quickly.

Will I sacrifice my care quality with a behavioral health APP?

Not at all. You will actually get better care from a multidisciplinary team that includes behavioral health APPs. Patients who want or need to see a physician will be able to, and all patients will meet with a physician as needed. However, many patients enjoy the personalized attention, advocacy and responsiveness they get from their behavioral health APP.

What do behavioral health APPs do?

• Behavioral health APPs correctly assess medical situations.
• They review labs.
• They order tests and diagnostics.
• They make a diagnosis.
• They prescribe appropriate treatments, including medications.
• They coordinate with the attending behavioral health physician as needed.

Why consider a hospital or outpatient medical practice that uses a care team model with APPs?

Having a behavioral health APP as part of a patient’s care team offers patients the most comprehensive care because it adds enhanced nursing care, resulting in a collaborative medical approach that includes the best of both physician and nursing practice. Essentially, you have two behavioral health practitioners on your team, rather than just one.

What about insurance reimbursement?

Medicare and Medicaid recognize APPs, and most private insurers do as well. Here at Inova, we work with our billing partners to make sure our billing and coding procedures are appropriate, to make sure our patients don’t end up with unexpected bills.

Tips to help patients work with behavioral health APPs

1. Always know who the members of the care team are – for example, yours might include your behavioral health APP, nurse, social worker and attending physician.
2. Behavioral health APPs have prescription and diagnostic knowledge, so they can answer questions about medications, including expected side effects, benefits and doses.
3. Behavioral health APPs also have a good sense of the overall treatment plan, so they can be a great resource for questions about treatments and lab studies you’ll have.
4. Talk with your behavioral health APP about your current working diagnosis, how the team developed it, and what it means for you.
5. Ask your behavioral health APP about your discharge plan. What are the next steps for you when you leave the hospital setting?

Because behavioral health APPs oversee your day-to-day care, they’re always advocating for you. They get to know your story and where you’re struggling – and they’re here to help. Having a behavioral health APP on your team means more quality care for you.

Learn more about Inova Behavioral Health Services or about Inova’s adult mental health inpatient services specifically. You can also learn more about the Behavioral Health APP Fellowship Program at Inova.