No Prior Auth

Lindsay Hill, DNP, PMHNP-BC
  • 5.0 (2)
  • Education

You don't need permission to build the career you want. That's the whole point. No Prior Auth is a podcast hosted by Lindsay Hill where psychiatric nurse practitioners who've built their own private practices share exactly how they did it. The real version, not the highlight reel. Each episode is a conversation that feels like catching up with a friend who already figured out the thing you're losing sleep over. How they landed their first patients. What they got wrong with credentialing and billing. How they set their rates, hired their team, and stopped charting at midnight. The business decisions that worked, the ones that didn't, and what they'd do differently if they started over tomorrow. If you're a psych NP thinking about going out on your own, already in the early stages, or trying to grow what you've started, every episode gives you something you can actually use. Real strategies from real providers who built it from scratch. Hosted by Lindsay Hill, DNP, PMHNP-BC, founder of the Psych NP Fellowship, a 12-month mentorship for psychiatric nurse practitioners: https://psychnpfellowship.com/

  1. 4d ago

    “Providers Who Use AI May Replace Providers Who Don’t” - Rebecca DePalma, PA-C

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Rebecca DePalma works from a home office, Monday through Wednesday. From that desk she's co-written a psychiatric reference text, precepted more than 80 PA students, taught psychopharmacology for PA programs, joined Psych Congress Elevate's New & Emerging Voices, and built a national speaking career — a few years out of training. If you practice remotely and quietly wonder whether that caps your career, this episode is your answer. We cover why she chose PA over MD (lateral mobility), how she fell into psychiatry and never left, the DMSc demystified, the honest answer to how her private practice fills, the "medical Instagram" with zero patients on it by design, how her preceptor asked her to co-write First Line Guide, the speaking snowball that followed, her networking rules (show up, serve the other person, and actually do what you say), how Mike Asbach slid into her DMs, and the AI-in-psychiatry conversation — including the line everyone quotes: providers who use AI may replace providers who don't. Timestamps: 00:00 Cold open: seats at tables, and the AI line 01:40 Does remote work mean a smaller career? 02:45 Why PA over MD: lateral mobility 05:58 The DMSc, explained 09:04 How the practice actually fills (the honest answer) 10:20 The "medical Instagram": zero patients, on purpose 12:09 The book: when your preceptor asks you to co-write 22:34 The networking masterclass: do what you say 28:10 AI in psychiatry (and her new faculty topic) 31:38 Where to find her Connect with Rebecca: First Line Guide on Amazon (https://a.co/d/089xPRMi) • Instagram + TikTok @RebeccaWestCoastPA • LinkedIn: linkedin.com/in/rebecca-depalma Watch on YouTube: https://www.youtube.com/playlist?list=PL2xQMQAfCsq3OrVz3RTndA80gfFEFOsez More episodes: https://psychnpfellowship.com/podcast/ Community: https://www.skool.com/psych

    “Providers Who Use AI May Replace Providers Who Don’t” - Rebecca DePalma, PA-C

  2. Nov 3

    No One Would Hire Him, So He Built His Own Practice

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Allen Ripors counted his patients right before we hit record: sixty. His practice is one year old, he started it with less than $1,000, and nobody planned any of it — least of all him. Psych had gotten oversaturated, every job wanted experience he didn't have, and the last practice owner he sent his resume to wrote back: "I'm hiring, but I don't think you're a good fit... you're better suited to do solo practice. I will mentor you." Allen is a Navy veteran and dual board-certified FNP and PMHNP in California, and this is year one exactly as it is: Headway's strengths and limits (including the per-visit fee announced the day we recorded, and the clarification from my Headway contact), the $73 ZocDoc booking fee and the personal phone call that beats it, launching for under $1,000 with a $700/month collaborating physician, skipping the $15,000 lawyer for a self-filed nursing corporation, doing real psychotherapy as a prescriber (ERP, habit reversal), board prep ranked by someone who tried them all, the office hunt he announced on this show, and the 20-hour job offer he just accepted alongside the practice — because that's the honest shape of a first year. Timestamps: 00:00 Cold open: "I didn't plan on it. It just happened." 02:23 Navy corpsman, hospital ships, ten ER years 05:44 The practice he never planned 07:11 Headway, and the fee news that broke mid-episode 08:50 "I'm hiring, but you're not a good fit" 13:08 The $73 ZocDoc fee, and the phone call that beats it 17:55 Startup math: under $1,000 + $700/month collaborator 20:15 Skipping the $15,000 lawyer 25:11 Yes, he does therapy: ERP and habit reversal 27:40 Board prep: he tried them all 35:21 The 20-hour job offer he just took 46:38 What "No Prior Auth" means to Allen Connect with Allen: Copen Health & Psychiatry — https://www.psychologytoday.com/us/psychiatrists/copen-health-psychiatry-l-allen-ripors-np-lake-elsinore-ca/1623493 Watch on YouTube: https://www.youtube.com/playlist?list=PL2xQMQAfCsq3OrVz3RTndA80gfFEFOsez More episodes: https://psychnpfellowship.com/podcast/ Community: https://www.skool.com/psych

    No One Would Hire Him, So He Built His Own Practice

  3. Oct 27

    Earn Your Spot on the Stage” | Miriam Dineen, MMS, PA-C, CAQ-Psych

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Miriam Dineen had no training in sexual addiction. Her patients brought it to her anyway, and instead of referring the topic away, she learned it — all the way to a national stage at Psych Congress. That's how she does everything, and this episode is the pattern. Miriam is a psychiatric PA with the CAQ in psychiatry and the lead clinician at Banyan Integrated Health in Winston-Salem. She spent ten years in internal and integrative medicine before the pandemic pulled her into psychiatry, and her bridge between those worlds was Chris Aiken, our Season 2 premiere guest — she worked with him for years at the Mood Treatment Center. We cover the career leap, what the CAQ is, approaching sexual addiction and the other topics clinicians avoid (start with a certified sex addiction therapist), integrative psychiatry without the snake oil, and the full speaking playbook: eight-hour drives for free talks, the call-for-speakers formula, the Psych Congress New & Emerging Voices mentorship, and why the cold DM works. Plus Lindsay's own confession about performance anxiety and the October conference where she finally speaks. Timestamps: 00:00 Cold open: the subject nobody trained her for 02:19 Ten years in internal + integrative medicine 04:40 The Chris Aiken connection and the pandemic pull 07:31 Working with Aiken: lectures, open doors, a Carlat journal club 11:19 Sexual addiction: the patients brought it to her 15:29 Integrative without the snake oil 19:34 Eight-hour drives to speak for free 28:03 Free talks to paid stages: the formula 29:45 New & Emerging Voices and Brittany Albright's mentorship 33:15 New-grad job advice: the fortune is in the follow-up 35:41 What "No Prior Auth" means to Miriam Connect with Miriam: Banyan Integrated Health - https://www.banyanintegratedhealth.com/miriam-dineen LinkedIn: https://www.linkedin.com/in/miriam-dineen/ Watch on YouTube: https://www.youtube.com/playlist?list=PL2xQMQAfCsq3OrVz3RTndA80gfFEFOsez More episodes: https://psychnpfellowship.com/podcast/ Community: https://www.skool.com/psych

    Earn Your Spot on the Stage” | Miriam Dineen, MMS, PA-C, CAQ-Psych

  4. Oct 20

    The Importance of Niche Expertise: How Kim Meehan Became a Leading Voice in Perinatal Mental Health

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Kim Meehan has 185,000 followers, and if a client finds her through social media, she refers them to somebody else. On purpose. She's had a six-month waitlist for four years and has never paid a dollar for marketing. This episode is the how. Kim is a perinatal psych NP who spent eight years treating anxiety and depression before an emergency C-section, a NICU stay, and a pregnancy loss showed her the other side. We cover her contrarian strategy (market to the therapist who refers, not the patient who follows), the coffee-chat system behind 90% of her referrals, her honest Headway history and how she de-paneled while keeping 80% of those clients, running a 250-client solo practice at one new intake a month, the 28-weeks story behind her perinatal niche, This Is Motherhood and the affiliate money she refuses on purpose, growing a Substack from 1,000 to 19,000 subscribers in ten months, and her resource list for psych NPs: Carlat, Simple and Practical, OpenEvidence, and the PSI training. Timestamps: 00:00 Cold open: the take most marketers would hate 03:38 The contrarian rule: refer away social-media clients 11:19 Headway and Alma: her honest history 14:14 De-paneling, and keeping 80% of those clients 15:32 Solo by choice: 250 clients, one intake a month 17:54 Born at 28 weeks: the story behind the perinatal niche 23:48 This Is Motherhood: Meta pay, no affiliates on purpose 26:29 Substack: 1,000 to 19,000 subscribers in ten months 44:51 Is the PSI certification worth it? 48:41 "Dream big": what she'd tell herself five years ago Connect with Kim: This Is Motherhood on Substack - https://substack.com/@thisismotherhood1 - and Instagram @thisis.motherhood_ Watch on YouTube: https://youtu.be/s06oCLW0MPU More episodes: https://psychnpfellowship.com/podcast/ Community: https://www.skool.com/psych

    The Importance of Niche Expertise: How Kim Meehan Became a Leading Voice in Perinatal Mental Health

  5. Oct 13

    Are You Coding Your Psych Visits Wrong? (A Medical Auditor Answers) No Prior Auth with Crystal Stone - S2.E2

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Crystal Stone has sat on every side of your insurance claim: the psych NP who delivers the visit, the certified coder who submits it, the biller who chases it, and the medical auditor who reviews it. She's an Air Force veteran and the founder of three businesses in Southern Illinois, including a billing and auditing firm with the motto "Professional on Paper. Savage in Appeals." We cover the 99214 and 90833 myths she keeps seeing on social media, in-network vs. out-of-network billing from zero, her warnings about Headway and Alma (PHI access, credentialing roadblocks, clawbacks), why your NPI makes you the responsible party no matter who bills, the audit-proof note formula (target, intervention, response, progress, plan, time), and where audit risk really comes from. Plus the story behind it all: the Air Force, an adult ADHD diagnosis in nursing school, and the day she fired her biller and learned to do it herself. This episode is education, not billing or legal advice. Payer rules vary, so verify everything for your own practice. Timestamps: 00:00 Cold open: "I see a lot of fraud" 02:04 Her story: the Air Force, ADHD, firing her biller 13:11 In-network vs. out-of-network, from zero 18:34 The Facebook billing myths that scare her 19:44 Headway, Alma, and the VC platform problem 27:21 Clawbacks and your NPI 39:45 The audit-proof note formula 44:47 The right code, not the highest code 46:30 What "No Prior Auth" means to Crystal Connect with Crystal: https://www.newleaf618.com/ (she also teaches a monthly billing and coding series with Psychiatry Circle) Watch on YouTube: https://www.youtube.com/playlist?list=PL2xQMQAfCsq3OrVz3RTndA80gfFEFOsez More episodes: https://psychnpfellowship.com/podcast/ Community: https://www.skool.com/psych

    Are You Coding Your Psych Visits Wrong? (A Medical Auditor Answers) No Prior Auth with Crystal Stone - S2.E2

  6. Oct 7

    Dr. Chris Aiken: "The Depression Add-Ons You Use Every Day Don't Work" S2.E1

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Dr. Chris Aiken opens this episode with a sentence that could change your prescribing. The add-ons most of us reach for in treatment-resistant depression — bupropion, mirtazapine, buspirone, even stimulants — have failed their large randomized trials. Unanimously. "California rocket fuel" went down in three of them. Meanwhile the treatments with real evidence behind them, like TMS, lithium, and pramipexole, almost never show up in the chart before a patient reaches him. If that name sounds familiar, it should. Chris Aiken is the editor-in-chief of the Carlat Psychiatry Report and co-host of the Carlat Psychiatry Podcast with psych NP Kellie Newsome: 700 episodes, more than 13 million downloads, and not a dollar of industry money, ever. He started at the NIMH at eighteen, trained at Yale, Cornell, and Duke, and wrote Bipolar, Not So Much and Difficult to Treat Depression. One more thing. A month ago, he and Kellie got married at the Chelsea Hotel. The podcast couple is now an actual couple. From there we cover a staggering amount of ground: lithium orotate without the hype, deprescribing when a patient walks in with five diagnoses and ten medications, and the Lindsay Clancy case, where he explains why postpartum psychosis belongs at the top of the diagnostic hierarchy and points out that a psychiatric NP was the one who finally raised the bipolar flag. He gives his honest read on keto and GLP-1s versus their actual trial results, names his three desert-island books, shares the daily ritual that keeps him current (scanning up to 100 new abstracts every morning), and tells the private-equity story he calls a regret, plus the pivot that became Psych Partners, which hires psych NPs. We finish on AI in practice, including Danny Carlat's eyebrow-raising "that might be malpractice" line, and on writing as the way out of rumination. I also share something I haven't said on this show before: I went through TMS myself last summer, and what it did for my own rumination surprised me. If you prescribe for depression, this is the hour. Go listen. Then tell me which part landed. — Lindsay CONNECT WITH DR. AIKEN 🌐 chrisaikenmd.com — he posts one new study a day (@chrisaikenmd on every platform) 📰 The Carlat Psychiatry Report: thecarlatreport.com 🎙️ The Carlat Psychiatry Podcast (with Kellie Newsome, PMHNP) 📚 Bipolar, Not So Much · The Depression and Bipolar Workbook · Difficult to Treat Depression (audiobook on Audible) · supplement guide with Dr. Carlat coming soon 🏥 Psych Partners (NC/SC/VA — and they hire psych NPs): psych-partners.com 🌐 Website: https://psychnpfellowship.com/podcast/ 👥 Community: https://www.skool.com/psych #PsychNP #PMHNP #Psychiatry #TreatmentResistantDepression #Bipolar #Lithium #MentalHealth #NoPriorAuth

    Dr. Chris Aiken: "The Depression Add-Ons You Use Every Day Don't Work" S2.E1

  7. Jul 28

    He Hates Networking. It Built His Entire Career.

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Mike Asbach is the first physician associate on this show, and he set the bar high. He's the Associate Director of Interventional Psychiatry at DENT Neurologic Institute in Buffalo, where he leads a team of 17 prescribers delivering TMS, ketamine, and Spravato. He's also the AAPA's liaison to the American Psychiatric Association, a professor, a medical writer, a podcast host, and a captain in the Army Reserve. Here's what surprised me: he hates networking. A perfect night for Mike is a good book and a quiet porch. Nearly everything on that resume exists because he overrode that preference, introduced himself to conference speakers, sat through the mixers, and kept showing up. It's how we met, at a schizophrenia ad board in Arizona. A two-minute conversation with him on his way to the airport put biotech consulting on my radar, and I've since done it. He never planned on psychiatry. Male PA students went into surgery or ortho, so that was his plan too, right up until he pictured himself at 35 getting called in for a hip fracture on Christmas Eve. He applied to one psychiatry job on a whim. Mid-interview, the medical director walked him down the hall, put a TMS magnet over his palm, and made his hand jump. That was it. Fifteen years later he's still there, four doors down from the same boss. We get into career design: how to move toward 0.7 FTE clinical without taking a pay cut, and why teaching scales in a way one-on-one patient care never will. We talk about money, a subject providers are trained to avoid, and where the line sits between a social media presence that builds trust and one that costs it. He's honest about the weight of this work too. Our patients come to us on the worst day of their lives, and for us it's a Tuesday. Then he tells the story behind his industry work. His sister-in-law has cystic fibrosis, and when she married his brother they hoped she might reach 35. A drug approved in 2019 changed her expected lifespan to nearly normal, and Mike now has two nephews who wouldn't exist without it. He's clear-eyed about profit motives, and just as clear about what that innovation gave his family. If you're a psych NP or PA wondering whether this career comes in a version with more range and less grind, Mike is proof that it does. CONNECT WITH MIKE: https://www.linkedin.com/in/michael-asbach/ Associate Director of Interventional Psychiatry, DENT Neurologic Institute (Buffalo, NY) 🎙️ Co-host, White Coats of the Round Table - https://www.masterclinicians.net/podcast-whitecoats LISTEN TO NO PRIOR AUTH 🎥 YouTube: https://www.youtube.com/playlist?list=PL2xQMQAfCsq3OrVz3RTndA80gfFEFOsez 🍎 Apple Podcasts: https://podcasts.apple.com/podcast/id1893233469 🎧 Spotify: https://open.spotify.com/show/5tNbJqeMERnglfTHedOhym 🌐 Website: https://psychnpfellowship.com/podcast/ 👥 Community: https://www.skool.com/psych #PsychPA #PhysicianAssociate #PMHNP #InterventionalPsychiatry #TMS #Ketamine #MentalHealth #NoPriorAuth

    He Hates Networking. It Built His Entire Career.

  8. Jul 21

    How to Find a Preceptor (and Not Waste Your Clinical Hours)

    Got something to say to this podcast? Send a voicemail, and you might hear yourself on the next episode! Andrea Kemp is back for Part 2, and this one is for the students. If Part 1 took you inside the inpatient unit, this is the practical playbook: how to find a preceptor when your program won't, how to walk into day one of clinical ready, and how to actually learn once you're there instead of watching someone else work. Andrea has precepted students for years and now teaches in a PMHNP program, so she sees both sides. She's blunt about what separates the students who get hired from the ones who get forgotten, and almost none of it is knowing every diagnosis. Show up with a notebook, not an iPad. Make yourself an asset, not a liability. Ask three good questions at the end of the day and look up the rest yourself. Curiosity over confidence, every single time. The part that stuck with me: your didactic classes teach you how to be a provider, but your clinicals teach you how to be in a room with a human, and those are two different skills. Andrea walks through how she actually talks to patients — the five questions she never skips, why silence is a tool, why she'd rather ask a hard question than let someone off the hook, and how she narrows two hundred medications down to five without ever tricking anyone into a prescription. We also get into the stuff nobody warns you about. Paying for clinicals. Preceptors who don't know how to use you. What to do when a patient doesn't want to be there. And how to protect your license when the board holds NPs to a harder line than physicians, including the state-board resource most students don't know exists. If you're in a program right now, or about to start clinicals, take notes on this one. Go listen. Then tell me what you wish you'd known sooner. — Lindsay LISTEN TO NO PRIOR AUTH 🎥 YouTube: https://www.youtube.com/playlist?list=PL2xQMQAfCsq3OrVz3RTndA80gfFEFOsez 🍎 Apple Podcasts: https://podcasts.apple.com/podcast/id1893233469 🎧 Spotify: https://open.spotify.com/show/5tNbJqeMERnglfTHedOhym 🌐 Website: https://psychnpfellowship.com/podcast/ 👥 Community: https://www.skool.com/psych #PsychNP #PMHNP #PMHNPstudent #NPschool #NursePractitionerStudent #ClinicalRotations #MentalHealth #NoPriorAuth

    How to Find a Preceptor (and Not Waste Your Clinical Hours)
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Ratings & Reviews

5
out of 5
2 Ratings

About

You don't need permission to build the career you want. That's the whole point. No Prior Auth is a podcast hosted by Lindsay Hill where psychiatric nurse practitioners who've built their own private practices share exactly how they did it. The real version, not the highlight reel. Each episode is a conversation that feels like catching up with a friend who already figured out the thing you're losing sleep over. How they landed their first patients. What they got wrong with credentialing and billing. How they set their rates, hired their team, and stopped charting at midnight. The business decisions that worked, the ones that didn't, and what they'd do differently if they started over tomorrow. If you're a psych NP thinking about going out on your own, already in the early stages, or trying to grow what you've started, every episode gives you something you can actually use. Real strategies from real providers who built it from scratch. Hosted by Lindsay Hill, DNP, PMHNP-BC, founder of the Psych NP Fellowship, a 12-month mentorship for psychiatric nurse practitioners: https://psychnpfellowship.com/

Information

  • Creator
    Lindsay Hill, DNP, PMHNP-BC
  • Years Active
    2026
  • Episodes
    22
  • Rating
    Clean
  • Copyright
    © Lindsay Hill 2026
  • Show Website
    No Prior Auth

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