Deep Dive with Lindsay Hill, DNP, PMHNP - Psych NP Mentor - PMHNP Mentor

Lindsay Hill
  • 3.9 (7)
  • Mental Health

Welcome to my podcast. I am Lindsay Hill, DNP, PMHNP BC, and this show is my space to slow down and really unpack what psychiatric care looks like in real life. Each episode is built from the learning that shapes our work in mental health: lectures, clinical meetings, medication updates, webinars, books, and the conversations that make you stop and think. We will dig into the details that matter, like diagnostic clarity, treatment planning, psychopharmacology, side effects and monitoring, comorbidities, therapeutic approaches, patient communication, and the practical judgment calls that rarely fit into a tidy script. My goal is simple: take complex topics and make them feel understandable, usable, and grounded. Whether you are a student, a clinician, or someone who loves learning about the mental health field, you will leave with clearer frameworks, helpful reminders, and takeaways you can bring back to your practice and your life. Thanks for being here. Let’s dive in. This podcast is for education and discussion only and is not medical advice.

  1. 6d ago

    S2E63: PMHNP Collaborative Care Consultant: 2026 Career Guide

    Hey! I'd love to hear your thoughts, send me a voice note. Medicare's Collaborative Care model needs a psychiatric consultant, and most PMHNPs qualify. How the role works, who bills, and how to contract for it. In this Deep Dive episode, two hosts walk through “PMHNP Collaborative Care Consultant: 2026 Career Guide” from the Psych NP Fellowship blog by Lindsay Hill, DNP, PMHNP-BC. Key takeaways: • CMS defines the Collaborative Care psychiatric consultant as a medical provider trained in psychiatry and qualified to prescribe the full range of medications. Most PMHNPs meet that definition. • The consultant usually never meets the patient. The job is a weekly caseload review with a behavioral health care manager, typically done remotely, plus quick questions between reviews. • The primary care practice bills CPT 99492, 99493, 99494, or G2214. The consultant gets paid by that practice under a contract or employment agreement and does not bill Medicare for these codes. • The University of Washington AIMS Center budgets 2 to 3 hours of consultant time per week for each full-time care manager. • In the IMPACT trial, 45% of older adults in Collaborative Care had at least a 50% drop in depressive symptoms at 12 months, compared with 19% in usual care. • The risk sits in the contract: scope rules in restricted-practice states, malpractice coverage for indirect consultation, and licensure where the patients live. Read the full article: https://psychnpfellowship.com/pmhnp-collaborative-care-psychiatric-consultant-2026/ Explore the Psych NP Fellowship: https://psychnpfellowship.com/programs/ This content is for educational purposes and does not replace individualized clinical judgment or supervision.

    S2E63: PMHNP Collaborative Care Consultant: 2026 Career Guide

  2. Sep 14

    S2E62: PMHNP No-Show Policy: A 2026 Private Practice Playbook

    Hey! I'd love to hear your thoughts, send me a voice note. Medicare allows no-show fees, Medicaid doesn't, and a missed psych visit can signal real risk. The 2026 PMHNP no-show policy playbook for private practice. In this Deep Dive episode, two hosts walk through “PMHNP No-Show Policy: A 2026 Private Practice Playbook” from the Psych NP Fellowship blog by Lindsay Hill, DNP, PMHNP-BC. Key takeaways: • At a 15 percent no-show rate, a solo PMHNP with 60 weekly follow-ups loses about 9 visits a week. At $150 a visit, that is roughly $65,000 a year. • Medicare allows a missed-appointment fee only when one written policy and one dollar amount apply to every patient. Bill the patient directly and never submit it to Medicare. • CMS policy bars billing Medicaid beneficiaries for missed appointments, whatever they signed. Exempt them, and dual-eligible patients, in writing. • Patients with long-term mental health conditions who missed more than two primary care appointments a year had over 8 times the all-cause mortality risk of those who missed none, in a Scottish national study. • Two text reminders cut missed appointments at four London community mental health clinics from 36 percent to 26 to 27 percent. • Sequence matters: a clinician reviews high-risk no-shows the same day, and billing waits until that check is done. Read the full article: https://psychnpfellowship.com/pmhnp-no-show-policy-private-practice-2026/ Explore the Psych NP Fellowship: https://psychnpfellowship.com/programs/ This content is for educational purposes and does not replace individualized clinical judgment or supervision.

    S2E62: PMHNP No-Show Policy: A 2026 Private Practice Playbook

  3. Jul 17

    S2E61: Countertransference as Clinical Data: A PMHNP Field Guide

    Hey! I'd love to hear your thoughts, send me a voice note. In this deep-dive episode, we unpack Countertransference as Clinical Data: A PMHNP Field Guide. Audio Overview Listen to an in-depth podcast of this post Two hosts break down the full article — no reading required. Your browser does not support audio playback. TL;DR Countertransference is the clinician’s emotional reaction to a patient. It is not a professional failing — it is clinical data. Four reaction patterns (dread, savior pull, boredom, over-familiarity) signal specific diagnostic dynamics. A three-step in-session protocol — Notice, Name, Neutralize — takes under 90 seconds and builds a pattern library over months. Acting on countertransference without supervision is the clinical risk. Having it is not. Early-career PMHNPs who track reactions and bring them to supervision move from reactive to formulated practice within 18 months. In this guide What countertransference actuall Read the full post: https://psychnpfellowship.com/countertransference-clinical-data-pmhnp/

    S2E61: Countertransference as Clinical Data: A PMHNP Field Guide

  4. Jul 16

    S2E60: Saying No to Controlled Substances: A New PMHNP Confidence Script

    Hey! I'd love to hear your thoughts, send me a voice note. In this deep-dive episode, we unpack Saying No to Controlled Substances: A New PMHNP Confidence Script. New PMHNPs get pressured, manipulated, and sometimes bullied into writing controlled substances they would not otherwise prescribe. Confidence is not about having a perfect answer — it is about having a rehearsed one. This post delivers a five-step refusal framework, exact patient-facing language, documentation pearls, and the mental reframe that stops most clinicians from caving under pressure. Read the full post: https://psychnpfellowship.com/saying-no-controlled-substances-new-pmhnp-confidence-script/

    S2E60: Saying No to Controlled Substances: A New PMHNP Confidence Script

  5. Jul 14

    S2E58: Modern Lithium Monitoring: The 2026 PMHNP Protocol

    Hey! I'd love to hear your thoughts, send me a voice note. In this deep-dive episode, we unpack Modern Lithium Monitoring: The 2026 PMHNP Protocol. Audio Overview Listen to an in-depth podcast of this post Two hosts break down the full article — no reading required. Your browser does not support audio playback. TL;DR Lithium remains the gold standard for bipolar maintenance and suicide prevention, but the 2026 monitoring protocol has evolved. New PMHNPs should narrow the maintenance target to 0.6-0.8 mEq/L, draw trough levels exactly 12 hours post-dose, screen every patient for GLP-1 agonist use before starting lithium, and coach hydration and sodium behavior as part of the monitoring plan. This post walks through the complete modern protocol — baseline workup, dosing strategy, draw timing, red flags, and the medication interactions that matter most right now. In This Guide Why Lithium Still Wins in 2026 The 2026 Baseline Workup Dosin Read the full post: https://psychnpfellowship.com/lithium-monitoring-protocol-pmhnp-2026/

    S2E58: Modern Lithium Monitoring: The 2026 PMHNP Protocol

  6. Jul 13

    S2E57: PMHNP Insurance Credentialing: Cut the 120-Day Wait to 45

    Hey! I'd love to hear your thoughts, send me a voice note. In this deep-dive episode, we unpack PMHNP Insurance Credentialing: Cut the 120-Day Wait to 45. Audio Overview Listen to an in-depth podcast of this post Two hosts break down the full article — no reading required. Your browser does not support audio playback. TL;DR Insurance credentialing for a new PMHNP usually takes 90 to 150 days per payer. A 16-week gap between diploma and first insurance check can cost $60,000 in delayed revenue. Five pre-application moves compress most timelines to 45-60 days. Supervision-required states (TX, FL, PA, others) add a separate approval step. Plan for it. California’s AB 890 independent-practice phase-in is live in 2026. The credentialing packet changed with it. The biggest revenue leak is not the wait. It’s the re-attestation lapse at day 121. In This Post Why the 120-Day Timeline Exists The Real Cost of Waiting The Five Pre-Application Moves What Read the full post: https://psychnpfellowship.com/pmhnp-insurance-credentialing-timeline-2026/

    S2E57: PMHNP Insurance Credentialing: Cut the 120-Day Wait to 45

  7. Jul 10

    S2E56: Handling Patient Pushback: A New PMHNP’s Confidence Playbook

    Hey! I'd love to hear your thoughts, send me a voice note. In this deep-dive episode, we unpack Handling Patient Pushback: A New PMHNP’s Confidence Playbook. Audio Overview Listen to an in-depth podcast of this post Two hosts break down the full article — no reading required. Your browser does not support audio playback. TL;DR. New PMHNPs rarely fail because of pharmacology gaps. They stumble when a patient pushes back and the clinician freezes, over-explains, or caves. This playbook shows a 3-step script — Acknowledge, Anchor, Advance — that holds clinical ground, protects the therapeutic alliance, and builds confidence in 60 to 90 days. Includes what most new grads get wrong, a named Fellowship drill, and a 6-question FAQ. In this article Why Patient Pushback Breaks New PMHNPs The Triple-A Script: Acknowledge, Anchor, Advance What Most People Get Wrong About Patient Pushback Four Pushback Scenarios and How to Handle Each The Weekly Debrief Dr Read the full post: https://psychnpfellowship.com/handling-patient-pushback-new-pmhnp-confidence-playbook/

    S2E56: Handling Patient Pushback: A New PMHNP’s Confidence Playbook

  8. Jul 9

    S2E55: Pramipexole for Treatment-Resistant Depression: What PMHNPs Should Know

    Hey! I'd love to hear your thoughts, send me a voice note. In this deep-dive episode, we unpack Pramipexole for Treatment-Resistant Depression: What PMHNPs Should Know. Audio Overview Listen to an in-depth podcast of this post Two hosts break down the full article — no reading required. Your browser does not support audio playback. TL;DR Pramipexole (Mirapex), a dopamine D3 receptor agonist FDA-approved for Parkinson’s disease, showed strong results in the PAX-D trial published in The Lancet Psychiatry for treatment-resistant unipolar depression. At a target dose of 2.5 mg/day added to existing antidepressants, patients saw significant symptom reduction by week 12, with benefits lasting through 48 weeks. PMHNPs should know the titration protocol, watch for impulse control disorders and nausea, and understand where this fits in the treatment algorithm after two or more failed antidepressant trials. In This Article Why Dopamine Matters in Treatment-Resistan Read the full post: https://psychnpfellowship.com/pramipexole-treatment-resistant-depression-pmhnp-guide/

    S2E55: Pramipexole for Treatment-Resistant Depression: What PMHNPs Should Know
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Ratings & Reviews

3.9
out of 5
7 Ratings

About

Welcome to my podcast. I am Lindsay Hill, DNP, PMHNP BC, and this show is my space to slow down and really unpack what psychiatric care looks like in real life. Each episode is built from the learning that shapes our work in mental health: lectures, clinical meetings, medication updates, webinars, books, and the conversations that make you stop and think. We will dig into the details that matter, like diagnostic clarity, treatment planning, psychopharmacology, side effects and monitoring, comorbidities, therapeutic approaches, patient communication, and the practical judgment calls that rarely fit into a tidy script. My goal is simple: take complex topics and make them feel understandable, usable, and grounded. Whether you are a student, a clinician, or someone who loves learning about the mental health field, you will leave with clearer frameworks, helpful reminders, and takeaways you can bring back to your practice and your life. Thanks for being here. Let’s dive in. This podcast is for education and discussion only and is not medical advice.

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