Nurse practitioners must navigate the sometimes-painful road of insurance claims, including different methods and timing of reimbursement, keeping up with patient subscriber numbers and local insurance carriers, handling designation as a specialist, obtaining prior authorization, and using the new national provider identifier, says NP Bonnie Hill, who owns Rowan Prime Care in Salisbury, N.C. She says, "All this may sound a little overwhelming, but, like riding a bicycle, once you learn how to do it, you never forget. You simply have to learn new 'tricks' to make the ride more enjoyable and less stressful."

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