I think I had about four years of experience
in psychiatric nursing before I applied for my
doctorate, and I ended up going to Rush University.
When was the first time you had the thought,
like, oh, maybe I would want to start my own
private practice? Do you remember that moment?
I knew I wanted to get good experience. Working
in community mental health, I got to see everything.
I was in the medication -assisted treatment program,
so I worked a lot with dual diagnosis and serious
mental illness. So I really got a good, strong
foundation. I think if you are like a solo provider
and if that's kind of easy for you, that might
be a good fit. I wanted to learn everything about
the business before I like delegated it out to
somebody else. So I learned how to do the credentialing
and then I kind of just chose that I was going
to do billing on my own for one insurance payer.
There's probably a lot of local networking events
that people are missing out on. So being consistent
with that, seeing how you can help other people's
practices too. Welcome to No Prior Auth. I'm
super excited about our guest today, Dr. Kaylee
Lenzicki. She is a psychiatric nurse practitioner
who has built and scaled a group practice that
is in Colorado and Illinois, and she's done it
while having four children. So that's pretty
incredible. She had two of the children as she
was building this. amazing practice that she's
built. So we're going to get to know her a little
bit more today and find out how she did it. One
fun fact for you guys is that Kaylee and I used
to work together back in the day in college.
Not in nursing, not in nursing. Something else.
Yeah. Yep. And so that's pretty, pretty funny
that we kind of like reconnected and it was in
Beaver Creek, Ohio. So it's a small world. Yes.
Where, where did we work? Worked at the buckle.
We did. I think we spent all of our paycheck
back at the buckle on jeans, essentially. Yeah.
Yeah. Yeah. Well, we did with the Miss Me's and
the gem jeans and the affliction tees. There
was a lot going on that season of our life. Absolutely.
So it's pretty cool to see how far we have both
come. And yeah, I just really can't wait to.
dive in and let you guys get to know Kaylee a
little bit more because she is pretty incredible.
So thank you for being here, Kaylee. Absolutely.
Thanks for having me. Happy to talk about my
journey. Awesome. So tell me a little bit about
when you knew you wanted to be a psychiatric
nurse practitioner, if you don't mind. Yeah,
I think it took me a while to get there. So you
and I went to college. We had a brief overlap
for a little bit. I was initially in the nursing
program. I planned to graduate a little bit early.
There was a mix up with how they had scheduled
my classes. So I was going to end up needing
to stay longer than I initially anticipated.
I fell in love with my Gen Psych class, just
found it completely fascinating, that side of
people. So I switched and I actually got a psychology
degree from Cedarville initially. And then, yeah,
I did. So I figured out I could do. I could get
a psychology degree and then I could go do an
accelerated nursing program and get both degrees
in the same amount of time it was going to take
me to get my nursing degree at Cedarville. So
that's what I did. Got my psychology degree and
then I moved to Chicago and I did an accelerated
nursing program at Loyola University. After that,
I guess with my background, kind of with my psych
degree and nursing degree, my first job that
was offered was at an inpatient psychiatric unit
in Chicago. And that was a great introduction
into psychiatric nursing. I have vivid memories
that first year of working on a psychiatric unit.
Loved doing it. Really enjoyed working with my
patients. Got to see a lot. Got incredible experience.
Worked at a couple of different hospitals doing
inpatient psychiatric nursing. Also would float
to the detox units as well. Then I kind of started
branching out and I got connected with... an
outpatient specialty mood disorder clinic where
they did transcranial magnetic stimulation. We
also did some clinical research on site as well.
So I did a little bit of outpatient, inpatient
at the same time, and just working really closely
with the psychiatrist who owned the practice.
I really wanted to become a psychiatric mental
health nurse practitioner. I think I had about
four years of experience in psychiatric nursing
before I applied for my doctorate, and I ended
up going to Rush University. So incredible school,
really fantastic. I felt like I got an amazing
education. The professors there were amazing.
I know I hear a lot about a lot of students these
days having a hard time finding preceptors. Rush
was amazing, just setting it all up with that.
And my preceptor was great. I got to stay with
him for an entire year, experience at all levels
of care. And I just felt like that really ready
to kind of enter in the nursing world as a prescriber
after that. So that was in 2017 that I graduated.
And my husband and I at the time, we have been
traveling a lot to Colorado. We really loved
the mountains, the nature out here. Really felt
like that was the state that we kind of wanted
to start a family. raise a family. And so that's
when we made the move, you know, not really knowing
anyone out here much at all. And we settled down
in Fort Collins, Colorado. I interviewed with
a couple of different places, but ended up at
a community mental health center, North Range
Behavioral Health in Greeley. It's about 45 minutes
away from here. And it was the best decision
as a new grad. Yes, it was probably lower paying
than a lot of the other jobs, but The experience
that I got and the mentorship that I got was
amazing. Dan France, who was my mentor, was amazing.
He actually, we actually just celebrated his
retirement this past weekend after 52 years in
nursing. So he's incredible. He's gotten a Florence
Nightingale award for his work. He was just absolutely
amazing. So I kind of told him like, he's kind
of partially to blame for all of this that's
happened right now with the practice. Yeah. Really,
really wonderful mentor. So. Yeah, very, very
grateful for that, that experience. And, you
know, I guess we'll get there. I can jump ahead
a little bit. So I just remember that huge panel
of people that were interviewing me for that
job as a nurse practitioner. Really? One of them.
Yeah. One of them is my now office manager. So
Sarah has come over and she's now my full time
office manager. So that's just beautiful. She
had an office right next to me. And I just love
that we've stayed in touch all these years. And
she's now over here full time. And then Heather,
who was another amazing mentor to me at North
Range, she is also in the process of switching
over to my practice now. So I just love like
we were connected almost 10 years ago. And now
two of them are over here in my practice. So
I was there for about four years. I had my son
in March of 2020. What a time to become a parent.
I was on maternity leave right as the world was
shutting down. But it was also kind of perfect
timing because that was the introduction into
telehealth for me. We kind of moved to telehealth
for a while. So that was a really perfect fit.
I could be working from home, didn't have to
go back into the office. I ended up, my second
son was born about a year and a half later. And
so again, went on maternity leave. And at that
point, people were, everyone was kind of starting
to transition back into the office. And it just
didn't make sense for me at that stage of life
that I was in to continue doing that commute
to Greeley as much as I love my patients, love
the people there, you know, wonderful practitioners.
So I moved to another company that was purely
telehealth where I could just stay home with
my kids. And that was great. For a while, things
went. really, really well there. I think you
and I are both in the integrative psychiatry
fellowship right now, but I actually got to...
Psych redefined? Yes. Yes. But I didn't realize
how lucky I was at the time. I got to work with
Dr. Peter Bongiorno on a lot of cases. So he
would actually come in and help me work with
cases on my patients. So that was kind of my
introduction into integrative psychiatry. So
Dr. B is great. yeah, admire him so much. So
I loved that piece of, you know, my previous
job where I got that introduction into integrative
psychiatry, diving into that a little bit more
with my patients. Again, all of my marks are
like all the children that I've had. So then
I had my daughter and this was, you know, late
fall of 2023 when I kind of went on maternity
leave. At that point, there started to be some
red flags that things with my company were not
going well. Like all of the... our virtual assistants
were like, let go overnight. And I just kind
of realized, okay, I'm going to need to pivot
and figure out like, what's the next best step
here. So was on maternity leave, kind of tried
to, I went way past why I wanted to be a psych
MP here, but all into the practice here. I have
so many questions. I'm like, this is so interesting.
I didn't know a lot of this stuff. Yeah. So I
was on maternity leave. Then that's when I. looked
around at other jobs and I just didn't really
find anything that was going to be a good fit
for me that I would felt super passionate about.
So I said, okay, well, this is kind of the push
that I need. Yep. I've had a lot of experience
as a psych MP. I feel ready to kind of jump into
the private practice thing. So that, that is
what kind of pushed me, pushed me into it at
that point. That's really interesting. Wow. Okay.
A couple things. Yes. Yes. So many, so many things.
I'm like, I just, well, yeah. You fell in love
with your psych class at Cedarville. And that's
kind of when you went and researched different
paths. And that's like, how did you even learn
what a psych NP was? I didn't even know about
psych NPs until I moved to Arizona. I don't think
at that point I knew I was going to be a psych
NP. I just knew I wanted to combine something
psychology and nursing. And I found this way
I could do this 13 month accelerated nursing
program at Loyola. after I already had a bachelor's
degree. So I just decided I was going to do the
combination of those two. And then again, I think
that just looked really appealing to an employer
that I had both of those. And I was offered day
shift as a new grad. So I said, yes, please.
I'll take that. Yeah. Yeah. That's amazing. That's
really cool. So you've had a passion for psych
for a very long time, it sounds like. Long time.
Yeah. People ask about the psych redefined. integrative
fellowship a lot. When did you join it and how
is it going for you? I joined it in July, so
like summer of last year. It's when I had my
fourth child, I think. I thought, you know, I'm
just going to, it's going to be paternity leave.
I'm going to try and take it easy a little bit.
This will be a great time to kind of take in
some additional information. So it has been great.
But yeah, I think looking back, I would have
probably waited until I was a little bit further
along postpartum before I joined it, but it's
been really amazing. I've been learning so much.
The genome mind stuff has been really fascinating
to me. Have you been getting into that? No, I
have not. Okay. I need to. I'm a little bit behind.
Yes, I am playing catch up a little bit too,
but it's been fun. My NPs are super passionate
about it as well. Three of us, we actually did
our own genome mind tests as well. That was really
fun just to kind of gain those insights into.
how we work in genetics, but we've been incorporating
that a lot into the practice. That's awesome.
Has it changed anything else in kind of the way
that you deliver care or interventions that you're
providing your patients? It's definitely helped
us be more precise in our care. Yeah, absolutely.
I love, we started accepting Medicaid and Medicaid
actually covers genome mind at a hundred percent.
So I love being able to offer that. Yeah. We've
had so many patients. who have Medicaid and it's
usually months for them to be able to get in.
We love that they're able to get in really quickly
with us and we're able to use that with them.
Wow. Very cool. So it's something you're ordering
quite a bit. It sounds like that you find helpful.
Absolutely. Yeah. We're going to start implementing
like a notes and neuro hour where we just talk
about genome mind stuff. Yeah. That's really
interesting. Love it. Okay, so when was the first
time you had the thought like, oh, maybe I would
want to start my own private practice? Do you
remember that moment? I think it was always in
the back of my mind. Okay. But I knew I wanted
to get good experience. Working in community
mental health, I got to see everything. I was
in the medication -assisted treatment program,
so I worked a lot with dual diagnosis, serious
mental illness. So I really got a good strong
foundation with everything. And I feel like that
is so important. I know there's a lot of different
takes on when to go into private practice. I
have, there's no way that I could have done it
with, without that foundation. Yeah. And being
able to go to my mentors and figure out how to
do things clinically before going off on my own.
Yeah. Same, same. I really needed that. So yeah,
I would have been crippled with anxiety if I
hadn't had that kind of like just in person.
support. You know what I mean? Because it was
just such a hard transition for me, you know?
Yeah. Yeah. So that's cool. Okay. So you launched
your practice in what year? It would have been
2024. So I had the PLLC established March of
2024. And then I think I was finally up and running
and started to see patients late that same summer
is when I was finally like ready to go. Okay.
How much did you spend roughly on starting your
private practice? I know that's something that
people are curious about and it's different for
everyone I ask. Yeah. I tried to keep it to the
basics and just spend money on the important
things and kind of spread it out a little bit
over time. I didn't want to go into debt for
the business at all. My in -laws, I come from
like a family of lawyers. So they were like,
you better do this right. Make sure. You connect
with a lawyer, make sure you have your PLLC set
up appropriately. I know each state is different,
whether it's LLC, PLLC for Colorado was recommended
PLLC for me. So I did get connected with a lawyer
to get all of that set up, consents, everything
that way. I want to say that was probably, it's
been a while, maybe three to 5 ,000 I spent with
a lawyer getting everything set up that way.
Okay. Next thing that I knew I wanted to do was
make sure my EHR was set up really good. I wanted
everything to be automated. I didn't want to
patch it together at the beginning. And then
when things got more busy, be scrambling to try
to figure out how this was going to work better.
So I did work with Silverleaf and they set up
IntakeQ for me and I've been really happy with
that. I think that was like two grand for them
to set it up and I would absolutely do it again.
It's been really great with it being so automated.
And those were the... main two costs that i had
was starting up the practice um yeah my website
i you know kind of got a template i did it on
my own i still do my own website um obviously
i had to get some business cards some marketing
material i remember like before my first networking
meeting i was like i don't have any business
cards like what do i do here so quickly i don't
threw it together just to make sure that i could
bring some business cards to to the first meeting
yeah yeah Yeah, I remember texting one of my
old bosses who like scaled a group practice and
sold it. And I was like, I'm supposed to meet
up with, you know, and talk about my practice
and I don't have anything. I'm freaking out.
And he's like, I built like a multi -million
dollar business with like stuff I had printed,
like, you know, whatever, just like donuts, like
nothing fancy or pretty. So it's doable. They
want to know who you are. Absolutely. I think
that's a lot of me pressing down my perfectionistic
tendencies. It does not have to be perfect. This
is good enough and it's going to work and go
with it and there'll be time later on to perfect
things. I think while all of that was going on,
that's when I reconnected with you. I'm not huge
on social media, but I've definitely... tried
to get on there for the business. Cause it is
so helpful. Like, yeah, I just started joining,
you know, all of these groups and your name came
up and I was like, wait a second. I know her.
Like, yeah, that's the girl I worked with at
buckle. So that's when I reached out to you.
And I remember we had a couple of Zoom meetings.
And yeah, you were talking me through kind of
starting the private practice. That was really
cool. Because yeah, we really didn't know each
other that well in undergrad. From my memory,
and this could be wrong, I feel like I was a
freshman when you were a senior. And I was just
like, oh, I like that girl. I look up to her.
She's so pretty. And for some reason, again,
correct me if I'm wrong, but I feel like you
wore Burberry perfume. That's what you said,
I think. I don't think I remember that. And you
said that wasn't true? I made this up? Oh my
gosh, I'm cracked up. I'm cracked up. Okay. Well,
I just remember like looking up to you. Yeah.
That's what I remember. It was super fun. I loved
our buckle days. Yeah. Yeah. Yeah, definitely.
Okay. Back to the private practice. Yes. Yeah.
Especially with all the nuance, with all the
changing laws, state specific. I do think that
that's a very wise investment. Get connected
with a lawyer. Yeah. Yeah. I think it's the best
money you'll ever spend on that. And so you found
your lawyer like within Colorado. How did you
find somebody you felt really good about? Especially,
I don't know if you knew at the time you were
going to be in Colorado and Illinois, but how
did you kind of vet finding that lawyer? I just
researched around like who kind of specialized
in mental health, looked at a few different places.
I've worked with a few different lawyers now
in Colorado for various things. Like when I expanded
to the group practice, I did end up working with
someone else who specialized a little bit more
in that. I know people. open up in multiple states,
I have really just focused on Colorado. Illinois,
I opened up because I had a huge Illinois caseload
for my previous job. I didn't solicit or anything,
but patients have the right to seek care with
the provider that they want. So I wanted a place
where they could at least land. So I did connect
with a lawyer also in Illinois and just make
sure that I was registered appropriately as a
foreign business entity, set up with everything
there. But I don't focus too much on growing
that side of the business. We definitely still
get inquiries. And I have a part -time NP who
sees patients for Illinois. But I really, I'm
like at capacity. I focus all on one state. Yeah.
Yeah. That's cool. That's really cool. Physical
office locations. Do you have those? Are you
all telehealth? Remind me. We are all telehealth
right now. Yes. So I have like an actual. you
know virtual address where all of the mail gets
forwarded i work with a you know we have technically
a physical location where we could see patients
so we have that as an option and that's definitely
something that i have in the back of my mind
i know Right now for the DEA, you don't have
to have that in -person visit for stimulants.
But what we've really come across in Colorado
is just a lot of pharmacies implementing their
own policies where they want that in -person
visit. So getting in the back of my mind, like
what's the backup plan going to be? And I would
probably just be, you know, subletting some offices
from therapists that we know throughout the state.
It's kind of nice. All of our providers are all
spread out throughout the state. So we cover
it pretty well, actually. That's really cool.
Yeah. So you've hired how many providers now?
I have four for Colorado and then I have one
for Illinois. Okay. Okay. And tell us about like,
well, actually I'm curious about two things.
Okay. You said you really weren't on social media
much and you kind of pushed yourself outside
of your comfort zone in that way. Has that been
like on Instagram, TikTok? Has it been for your
practice mainly or like your personal brand?
And what are the benefits? Because I think a
lot of people look at it and they're like, I
don't know if this is really worth it. Yeah.
I mean, if you go look at any of my profiles,
you're going to see there's not a whole lot on
there. It's really more of a way to make sure
people are able to get connected with the practice.
Yeah. Just being on a lot of the local mental
health Facebook groups, that's been really good.
Just staying connected and really getting connected
in with the local community. So I would say that's
been the main benefit with social media. So it's
all business stuff that I do with that. Yeah.
For your practice. Yes. And like awareness for
other people who refer to you and whatnot. Okay.
That's cool. Okay. One of the things that people
are talking about right now are working with
these platforms like Headway, Alma, Grow, Rula,
I think. Rula. I think it's another one. Yeah.
That's like the lab place. But anyway. Yeah.
So, you know, talk to me about like. Because
you didn't choose to use one of those for credentialing
or billing or getting patients. Talk to me about
your thoughts on that. We did work with them
for a little bit. Oh, I didn't know that. Yes.
So I went back and forth so much on what I was
going to do. And then initially when I was starting
up, I caved and I decided to go with some of
these billing platforms. Yeah. My experience
was... I just didn't like that I didn't have
control of the customer service. So a lot of
times the patients would be charged an incorrect
amount and it would be a really long time before
all of that would be resolved. I think if you
are like a solo provider and if that's kind of
easy for you, that might be a good fit. I wanted
to learn everything about the business before
I like delegated it out to somebody else. So
I learned how to do the credentialing and then
I kind of just chose that I was going to do billing
on my own for one insurance payer. just to see
like how it went, learn it all. We have pretty
much moved all in -house now with in -house billing.
And we actually are managing it all right now.
So dropping claims, following up on claim denials,
we kind of do it all. I was going to, you know,
contract with someone to kind of help with that.
It just didn't end up working out. And, you know,
I just kind of talked with my office manager
and we were like, you know, this is kind of going.
well now for like four or five months that we've
been doing it, you know, 99 plus percent of our
claims are getting paid. Like we were kind of
figuring this out. Yeah. So we're just continuing
to do in -house billing for now, but I really
like having control over it. I feel like it's
better customer service. These platforms don't
support Medicaid. We have some smaller local
plans that we contract with. So it's been just
a lot easier for us to move everything in house.
And it just seems like when I'm hearing with
these platforms, they're just asking for more
and more information. They're kind of starting
to act more like employers versus, you know,
the 1099 contractors. So I'm really proud of
us that we've kind of moved to all in -house
billing. Yeah. How are your rates compared to
like some of the platforms? I know that's one
of the reasons why people say that they sometimes
use them. Yeah. I mean, I'll be honest. It's
definitely not all of them are as good. as platforms.
Yeah, it is what it is. But you kind of what
I've gathered is you kind of have to get in at
the lower rate. And then the longer you stay
in, the more of a bargaining power you have with
the insurance companies to help improve your
rates. And I don't think that's going to happen
with these other billing platforms. I know some
of the rates have even been lowered since I've
been in for some of these insurance companies.
So I have no doubt that's just going to kind
of continue to trend that way. Yeah, that makes
sense. You and I both. worked with silver leaf
because it sounds like we both wanted that kind
of like automated experience but i'm pretty sure
correct me if i'm wrong that you and i both felt
like their forms well i'm sure they're audit
proof or quite like clunky with the clicks and
the right i trimmed them down quite a bit yeah
yeah i had figure out how to do that yourself
or you paid somebody i figured out how to do
that myself yeah you're scrapping Yeah. That's
why I said I'm a scrappy business owner. But
yeah, I had somebody who was also great with
audits and helping people with their templates.
And she kind of helped me figure out like what
is actually necessary, but was able to trim it
down quite a bit. I still feel like it was a
really good base, but yes, we did trim it down
a lot. Okay. So a patient coming to your practice,
like how do they get set up with you? What's
the process like? Yeah, we have the online scheduling
so they can really go in, they can search. Whatever
provider has the earliest availability or if
they feel like there's a particular provider
they connect the best with, then they can go
ahead and schedule with that provider. Okay.
If they have questions, they can reach out to
our office manager, call or text us. But usually
it's the online scheduling. They find us that
way. Okay. How did you find the providers that
you hired? I know you used to work with maybe
one or two. Yeah. So Sarah, my office manager,
when it was just me. And all of a sudden I was
getting completely just overwhelmed. I said,
you know, I cannot, I cannot do all of these
admin tasks on my own. I contacted her. So she
just started out like, you know, five to 10 hours
helping me. And then as the practice grew, she
started expanding her hours until it was a full
-time position. Yeah. So after I decided I did
the private practice thing and I was also doing
my W2 job at the same time. And it just got to
a place where I couldn't grow anymore in the
private practice unless I just made the leap.
So I made the leap. And then two weeks later,
I found out that that was when baby number four
was going to be coming. So I was like, OK, well,
I'm not really sure what this looks like. Am
I going to continue to do the solo practice thing
or does it make sense to do a group practice?
And I don't think it's always like the natural
progression to move from a solo practice to a
group practice. I mean, I would say I'm just
as busy, if not busier. It's just a different
type of work. that, that you're doing. So yeah,
kind of, it would have been a little over a year
ago, like March, I think I started, I posted
something on LinkedIn and then I posted on some
of the Facebook groups as well. I found, yeah,
my first two NPs that way. They are both amazing,
incredible, total rock stars, like love them.
They've been so great. LinkedIn or Facebook or
one of each? One found me through the LinkedIn
post. And then another one found me through Facebook.
So yeah, we had Amanda. She was the guinea pig.
She was the first one that came on as an MP and
she's been with us for almost a year now. Yeah,
she's incredible. And then Kat started a little
bit later, like in August, right as I was going
on maternity leave. And I feel like that was
really helpful to have too. I feel like it would
have been way too much for one person to be seeing
all of my patients as I tried to take a semi
-maternity leave while they were kind of growing
their own caseload. So I had the two of them.
Yeah, those were the first two. And then Rashawn
was the other one that I had connected with through
Facebook. She just hadn't graduated yet, but
really connected with her. Felt like she was
a really good fit. Hired her kind of last year.
And then by the time licensing, credentialing,
all that kind of came through, we're finally
getting her on board now. That's exciting. Yeah.
So you were working your corporate gig still
40 hours a week. For how long? I could drop down
to 30. You could technically drop down to 30.
And then I had a lot of paid time off saved up.
So I did a combination of that where I want to
say like for six weeks or so, I was able to do
20 hours, still keep benefits, still keep the
job and then really open it up in the private
practice. And then, yeah, felt like I never felt
fully ready to do it, but it was absolutely the
right time to make the leap full time. Because
were you doing your private practice like on
Saturday, Sunday type thing? Or how did you work
that? No, I kept it all during the week. Yeah,
it was really important for me to be there with
my family. So I don't think I had more than 40
hours open to patients. So maybe I had like 20.
So with my corporate gig and then 20 open to
private practice. Yeah. Okay. And when that was
full, I was filling up my lunch break, you know,
tagging patients on at the end of the day. I
knew it was ready to move. Okay. How long did
it take to get your first patient? Because I
know that's something where people will launch
and then they're like, where are the phone calls?
Why aren't people booking? What's happening?
Yeah. It was pretty immediate, really. Yeah.
I really dedicated myself to as much as I was
seeing patients, networking as much, if not more,
in the beginning. So you have to do a lot of
that groundwork too. And like just being genuine
about it too. Like if you're just going out being
like, give me patience, give me patience. People
are, they're not going to pick up on that. Our
goal is that we really have a lot of resources
for our patients. So it takes them a while to
be able to find a psychiatry provider that they
really connect with. They don't want to have
to go back out into psychology today world and
try and find a therapist that works as well.
So we know all of these wonderful, amazing therapists
that we're able to connect them with, you know,
neuropsych testing, sleep specialists. We just
have a whole bunch of resources. And I definitely
am so grateful for the Colorado mental health
community and how they've really embraced me
and the practice. There's no way I would be successful
without them. So love, love collaborating with
our therapists and mental health community. I
love that. I do think that there is something
to be said about like focusing on one state,
focusing on maybe your kind of like home state.
Like, yeah, I absolutely. see like significant
value in that and just doing that really, really
well. So that's cool. So you did your own credentialing
and your own billing. Would you recommend that
to somebody starting out? I would. I'm a firm
believer in figure out how everything in your
company works. And then when you have more money
than time at that point, then you can start to
delegate things out. When I bring a new provider
on, I don't do the credentialing anymore. That's
something that I hire somebody for. But I know
generally what the process looks like, what the
timeline looks like. So if something's going
wrong, I get a sense. But yeah, I've kind of
handed that over at this point. To a credentialing
company or to one of your virtual assistants
who you trained? It's a credentialing person
that I work with. She's been great. And then
I have another one that I kind of work with for
Colorado Medicaid. So I have one more for commercial
and then I have another one that I work with
for Medicaid. Okay. And did you just find those
word of mouth or how did you kind of vet those?
Facebook. Yeah. Word of mouth, Facebook. Yeah.
Facebook's kind of underutilized for some of
those like connecting. Yeah. There's just so
many resources on there. It's great. Is that
kind of where you, like when you were learning
how to credential yourself, like where were you
looking to or learning from to do it? Going straight
to the insurance websites. Yeah. Figuring out
how to do it there. Yeah. So if we were looking
at a pie chart of like where your referral sources
come from, what would you say that breakdown
looks like? Referrals from other mental health
practices, therapists, that's going to be the
vast majority. I would say, yeah, maybe 85 %
or so. Yeah. We all have Psychology Today profiles,
maybe 10%. I don't know where. And then I think
maybe just like word of mouth, like people are
talking about us again on social media. They
heard about us from a friend and have been recommended
to the practice. Okay. Gotcha. And you have your
own like Facebook, Colorado Psych NP group, right?
I do. I, a couple of years ago, again, I was
trying to look for it and there were no Colorado
PMHNPs Facebook group. So I started one. I think
there's a couple of hundred of us that are there.
And I just started like a virtual networking
group too. So it's the, it's the second Wednesday.
Yeah. Second Wednesday of the month that we meet
over lunchtime from 12 to one. So yeah, any Colorado
PMHNPs are welcome to join, but yeah, we just
kind of talk about how things are going. Everyone
is in different stages. Some are new grads. Some
have been there for a while. Some are working
for companies, private practices, group practices,
but it's just a good chance for us all to. connect
and see how we're doing. That's awesome. Talk
to me about when you knew it was time to hire
like for administrative support and kind of what
that process looked like. I remember just looking
at my schedule of all the intakes that I had
that following week. And I'm like, I have no
idea if these people have filled out their paperwork,
if they're ready to go, nor do I have time to
figure this out. That's when I had contacted
Sarah. She was the first person that came to
my mind, and I had worked with her for years
in community mental health. She's wonderful.
She has 20 years of experience in community mental
health, and she's so organized, just as organized
on top of things as I am, very detail -oriented.
So I didn't even consider anyone else at that
point. I knew Sarah was the right person to bring
on. So she's been... been absolutely amazing.
Once we kind of grew, so when we, when Rashawn
and Heather then added another five of us, one
that works part -time, we needed more admin support.
So I had worked with Ella at my previous job.
We had worked together for about four years,
you know, on a daily basis. She was kind of my
go -to person. So she was the second person that
I brought on. So right now we have two full -time
admin staff for our group. That's awesome. So
your providers that you brought on, are they
1099, W -2? And if you don't mind telling us
about kind of like how you made that choice,
because I think that's another thing people kind
of wrestle with. Yeah, this is a hotly debated
topic. I'm firmly in the W -2 camp for nurse
practitioners. Yes. I know there's kind of this,
oh, well, I'm not dictating their schedule or
they can work as much or as little as they want.
And, you know, again, after. Speaking with lawyers,
that's not the essence of a 1099. The IRS has
definitely put out new rules for what constitutes
1099 versus W -2. You essentially start with
the assumption that they are an employee, and
then only if you meet these certain criteria
could they technically be a 1099. But for most
states, if you're bringing someone on and they
are doing the core purpose of your business,
which for us is psychiatry and medication management,
they're an employee. So it's going to become
harder and harder, I think. I know there's a
lot of practices that do it. They practice that
way. Not here to speak on that, but for me, I
knew that to be right by my NPs, we definitely
needed to do W -2. So yeah, it's a W -2 position.
You know, we offer benefits to like the paid
time off, the sick time, you know, that they're
legally entitled to. We've got a 401k with match.
We've got, you know, CEU reimbursement, office
stipends. Yeah. Try to try to do as much as we
can for them. Yeah. Yeah. Very cool. Okay. Also,
you know, with all the networking that you did
with these like therapy offices or maybe. like
PCPs, like what did that look like? Was that
like going on the Facebook groups and then like
just cold DMing them? Like I guess I'm just trying
to help other people see that process a little
bit more because I think people underestimate
the amount of like networking and marketing that's
necessary, you know? Yeah. It's like it's showing
up in your community. There's probably a lot
of local networking events that people are. missing
out on. So being consistent with that. And again,
seeing how you can help other people's practices
too. Like not just being like, you know, send
me patients, but like, hey, this is a gap that
I'm seeing. You know, we definitely need more
neuropsych testing for our patients, specialized
therapists in this, specialized therapists in
that, but like being intentional about those
connections that you're making. So yeah. And
helping them out too. Like see somebody asking
for a therapist and you're like, oh, I know so
-and -so, they're going to be great for that.
Yeah. Kind of providing some value and nurturing
those relationships. Yeah, being intentional
and genuine. We all want the same thing. We want
great care for our patients. In five years from
now, what do you hope that present life psychiatry
looks like as well as kind of your day to day?
I never want to get away fully from patient care.
So I think I'm always going to have my own clinical
caseload of clients that I'll be seeing. Yeah,
no, we didn't really touch on this, but perinatal
psychiatry is kind of what I'm focused on. moving
forward. So that's my niche and the few new patients
that I'm accepting. That's what I'm doing. I
never would have anticipated that I would have
grown to a group practice, especially this quickly
when I first started it. So I'm not sure what
things are going to look like in five years.
I know for sure I don't want to grow to be something
super big where patients kind of get lost in
the mix. They don't have that direct access to
their providers. I know a lot of us do. We use
Spruce for messaging. So if they have any, you
know, quick concerns in between visits, I want
them to feel like they can easily access their
provider. And I want to be sure that patients
can get in quickly too. You know, in community
mental health, you're booked three months out.
So like, it's really hard for patients to get
back in. And then my other job, I was seeing
80 to 90 clients a week, and I'm just so burned
out by the end of it. So I definitely, you know,
want to keep it. keep it low, not having a huge
amount of patients that my providers are seeing
and making sure that the patients feel like they're
getting that holistic care. Everyone does a really
great job getting to know our patients, doing
a lot of supportive psychotherapy during their
visits, doing the lab work, more of the integrative
psychiatry supplements, genome mind testing.
So just really more, more holistic care. I think
potentially we could grow a little bit more and,
you know, add a couple more providers. But again,
I don't. anticipate it being anything big. I
want to keep it small, make sure patients feel
connected. Yeah, absolutely. What do you do to
kind of keep your mental health intact, having
four kids and then running this group practice?
I have great help outside of work too. So yes,
absolutely. Yes. Yeah. We have a wonderful nanny
so that, you know, it doesn't feel like where
I'm. half doing my work, half watching my kids,
you know, I can definitely have some time to
do that. My mom is incredible too. She absolutely
helps. So it just definitely, we have support
like outside of this that allows me to do this
work. But yeah, I love transitioning into this.
I feel like it's, this kind of honors the season
of life that I'm in right now, where it's not
so solely tied to only seeing clients. A lot
of the things that I do as a group practice owner,
it's a little bit more flexible. So it gives
me time where I can step out and I can put my
baby to bed. You know, I can nurse him. I can
feed him. I can do those things. So I love that
there's that flexibility built in. But there's
definitely, you know, a lot of late nights after
the kids are asleep where then I'm back to working
on things for the business. Yeah. Because is
your husband, like, does he have a full time?
Corporate gig? Yeah, we're both full -time, but
we actually both get to work from home as well.
We both have our dedicated office spaces, but
it is nice that we don't have these long commutes
that we have to worry about. So that's been great.
Yeah, because didn't you just go to Florida for
like a month or something? We did, yeah. We have
some family down there, but we were like, why
not? It's been a huge year just with expanding
to the group practice. and having a baby. So
we just needed some time, time to kind of get
away. So, so worked, you know, throughout, but
it was just nice to kind of have a change of
pace. Yeah. Yeah. That's really cool. That's
pretty huge to be able to like travel and then
also work a little bit and get to hang out with
your kids at the beach. I know. I love your traveling
like a lot too. I know we texted the other week
and you're like, I'll get back to you. I'm on
the beach now. So. Home exchange. Yeah. I can't
believe I'm not an affiliate for them. I'd be
doing great if I was because I'm like, everybody
needs to do home exchange. Yeah. Yeah. Any goals
for yourself for this next year as far as anything
really? Any like diversification of revenue streams?
Speaking? consulting, anything like that on your
radar? Are you pretty like? I want to do all
those things and jump into all those things,
but I have to be like realistic with myself.
Like that's probably not the time. I would love
to do some other things. I definitely, I've loved
kind of like transitioning into a group practice
and figuring all the ins and outs with that.
And I think definitely in the future, that's
something that, that I would offer. Like, this
is how you do it. This is kind of what I've learned.
Would love to do that sometime. But again. I've
got to focus on one thing at a time. So I think
we're just going to make sure, kind of focus
on filling the caseloads of our NPs that we have
right now. Definitely want to be learning more
about integrative psychiatry and incorporating
that more into our practice. But yeah, I have
big dreams and goals when things kind of settle
down a little bit for diversifying things. Totally
get that. Yeah. I also think there's something
to be said about being like very focused on kind
of making one thing. really excellent you know
because sometimes it's hard when you're like
working on all these things and you're distracted
and it's like you're kind of frustrated because
none of them seem to be thriving you know what
I mean right yeah I want to yeah exactly want
to do one thing well make sure that we're doing
well here absolutely yeah yeah it makes me think
about even like service lines I think sometimes
when you add on different service lines and you
don't have like your core service line really
like hashed out. That can be difficult too. Anything
else that you would tell a newer psych NP, any
advice in 2026 that you can think of? Yeah. I
feel like the job market is so different than
how it was when I started before, but if you
can. I would really strongly recommend like finding
a place, even if it is lower paying, if you can
somehow swing that to where it just has a good
mentor. That was just foundational for me and
I think is a core part of why this has been so
successful. But that was really, really amazing.
So yeah, jumping into community mental health,
that was great. So yeah, if you're able to find
it, I realize it's kind of hard, but I just had
such a great experience and that's also a huge
core part of my company that I wanted to pass
along to my NPs. pretty much always available.
Anyone has a question, we do weekly meetings
to review cases, talk through all of those things,
making sure that they have a good foundation
as well. Yeah. That's awesome. I ask all of my
guests this question, what does the term no prior
auth mean to you? Because that's obviously the
name of this podcast. Oh, it's like a daily frustration
that we go through. I would say, yeah. elimination
of inefficiency and, you know, unnecessary barriers
to care. Yeah. It is so frustrating to have to
go through, you know, jump through all of these
hoops just to get things approved, but yeah,
allowing us to practice at the full scope of
our license and really allow us to make those
decisions that are good for our patients. Now
we start time with those things. Yeah, exactly.
Love that. Where can people find you if they
want to kind of follow along? your journey or
what you're doing and your practice. Our website
is presentlifepsychiatry .com. You can find me
on Facebook, Bailey Lenzicki. We've got our practice
on there under present life psychiatry. Yeah.
I would love for any Colorado PMHNPs come on
over to our group, join our group, join our little
networking meeting. And then, yeah, you can find
us on, on Instagram too. Awesome. Well, thank
you so much for your time and would love to have
you on again in a couple months. And I know people
are going to be very invested in hearing how
you did it because it's very relatable to like,
especially us moms wanting to build businesses,
be entrepreneurial. We do it from the living
room, holding a baby. Yeah. My son was just knocking
here in the middle of this podcast episode. I
mean, it's just life, you know, but we just make
it work. So yeah. Thank you so much, Kaylee.
Yeah. Thanks, Lindsay.