She talks about launching Present Life Psychiatry in March 2024 while still working her W-2 job, spending $3,000–$5,000 on a lawyer and about $2,000 on Silverleaf to set up IntakeQ, doing her own credentialing by going straight to the insurance company websites, and learning billing on one payer before bringing it all in-house. She tried the billing platforms — Headway and others — and left because she couldn't control the customer service. Now her team drops claims, chases denials, and gets 99-plus percent of them paid.

She explains why she hired her office manager Sarah — who once sat on the panel that interviewed Kailee for her first NP job — and how she found her first two NPs through a LinkedIn post and a Facebook group. She breaks down why she's firmly W-2 for her providers, what benefits she offers, and how she thinks about the 1099 debate after talking to lawyers.

Kailee gets into the integrative psychiatry piece too. She's in the Psych Redefined fellowship with Lindsay, she's running Genome Mind testing on her NPs and her patients (Medicaid covers it at 100%), and she's building weekly case review meetings into the practice culture. She's moving her own clinical focus toward perinatal psychiatry and keeping the practice small on purpose — no 80-patient weeks, no three-month wait lists, direct messaging through Spruce so patients can actually reach their provider.

85% of her referrals come from local therapists she networked with in person. She started the Colorado PMHNPs Facebook group because one didn't exist, and she runs a virtual networking lunch on the second Wednesday of every month. Her son knocked on the door mid-recording. That's the reality. She builds the business from the living room, after the kids are asleep, with her husband working his own job from the next room over. And somehow, a month in Florida with the whole family still worked.

Lindsay Hill is a psychiatric NP and coach helping NPs scale freedom and impact.

No Prior Auth Podcast with Lindsay Hill, DNP, PMHNP-BC. Founder of The Psych NP Fellowship. Private Practice Owner, APNA - AZ Chapter Past President, Co-Founder of The Psych NP Network.

Many new graduates ponder the path to independence versus traditional employment. This discussion explores what it takes to build "self confidence" and embrace "entrepreneurship" early in one's career journey. We dive into essential "career advice" for those considering "how to start a business" right out of school, focusing on "personal growth" and the motivations behind such bold steps. 🚀

That's the kind of person Heidi is. Scared and doing it anyway.

In this episode, Heidi talks about going from substitute school nurse to board-certified PMHNP, graduating during COVID in 2020 after more than a decade of starting and restarting nursing school while raising three kids. She shares why she decided to skip the employed-provider route entirely and build Intersect Mental Wellness, a cash-pay telehealth practice launching across Arizona and Nevada with her husband handling the tech side.

She breaks down the real startup costs — roughly $10,000–$11,000 including a $7,500 attorney retainer for a healthcare-specialized law firm that handled federal and state compliance so she could sleep at night. She walks through the DEA registration process, why each state handles it differently, what a registered agent actually is (and that it costs about $35–$50 a year), and why she refused to take insurance after watching providers get paid and then forced to give the money back months later.

Heidi's advice to anyone behind her in the journey: ask everybody, start early, and swallow your fear. Don't let it make the decision for you.

Lindsay Hill is a psychiatric NP and coach helping NPs scale freedom and impact.

• In this episode, Allison talks about building At Your Service Psychiatry into a multi-state telehealth practice years before COVID made virtual care mainstream. She did 50 EHR demos, couldn't find what she needed, and built her own system. She walked away from insurance contracts, applied for licensure in 25 states, and figured out direct-to-consumer psychiatric care when most people thought telehealth was "just for rural."
• She also gets real about the hard stuff. A colleague getting stabbed by a patient. Losing patients to suicide and sitting through root cause analysis meetings. A very public meltdown on an inpatient unit that ended with her walking out for good. And how she processes all of it now, including breathwork, calling families, and giving herself exactly 30 minutes to obsess before putting it down.
• Then there's PMHScribe, the AI documentation tool she built from her own audit-tested templates after years of being flagged as a "high numbers provider." She designed it so the charting practically writes itself for the auditor. https://pmhscribe.com/

If you've ever thought about going independent, going telehealth, or building something that doesn't exist yet, this one's for you.