No Prior Auth

Lindsay Hill, DNP, PMHNP-BC

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

  1. 2d ago

    Inside Inpatient Psych: The Locked Door Isn't What You Think

    I went to school with Andrea Kemp at Arizona State, so I've watched her become one of the sharpest inpatient psych NPs I know. She almost went to law school. Psych won. Eleven years later she runs a step-down unit, teaches in a PMHNP program, and says the thing most people get wrong about inpatient psychiatry starts at the front door. That locked door? It isn't there to protect the world from the patients. It's there because someone is not safe, and the unit is where they finally get to be. Most of what you picture from TV is wrong, and Andrea spends this episode setting it straight. This is Part 1 of two, and we stay on the unit: what inpatient psych actually is, the medication puzzle she loves solving, and the hardest part of the job — involuntary treatment, and what it means to take someone's autonomy while still treating them like a person. Her rule has stuck with me. A patient may not remember the meds you gave them, but they will always remember whether you talked to them like a human being. We also get honest about safety. Andrea has been assaulted on the job, and she doesn't sugarcoat it. It's also, oddly enough, where she met her husband — he stepped in the day a patient's family member threatened her. She talks about all of it without flinching, and about why she still loves this work. And because she got hired five months before graduation and negotiated $130,000 as a brand-new grad, she walks through exactly how she pulled it off. If your first job is for learning and not earning, she'll show you how to still get paid while you learn. Come back for Part 2, where we get into prepping for clinical and everything she wishes psych NP students knew. Go listen. Then tell me what surprised you. — Lindsay CONNECT WITH ANDREA Inpatient-focused community for psych NPs & PAs — launching soon Speaking on NP decision fatigue at the Southwest NP Symposium (Mesa, AZ · late July) [add Andrea's TikTok / community link] 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 #InpatientPsych #PsychiatricNursing #MentalHealth #NursePractitioner #PMHNPstudent #NoPriorAuth

    Inside Inpatient Psych: The Locked Door Isn't What You Think

  2. Jul 7

    He Runs Ketamine and TMS — but Wants You on Less Medication

    Most of the guests on this show built private practices and never looked back. Ben Egbers is the outlier. He built one in rural Montana, and then he walked away from it. Ben came to psychiatry the long way. A psychology and German degree in 2000. Years as a case manager, then teaching English in Europe. An avalanche in the backcountry that he barely survived, and that he dug his best friend out of. A career in pharma he hated, a $60,000 pay cut to go back to bedside psych nursing, and his own recovery from alcohol use disorder — this month he's ten years sober. He didn't finish his nursing doctorate until 2021. Today he runs some of the most intensive treatments in the field, deep TMS and ketamine, while holding a belief that sounds almost backwards: the goal is the least medication a person needs, not the most. We get into all of it. Why he opened a private practice and then let it go (the billing alone will make you wince). How he partners with therapists in a way that has them telling him "you're the first psychiatric provider who ever called me." What ten years of sobriety taught him about who's actually ready for help. And why he's now stepping back from the interventional work to train in psychodynamic therapy and do something that feels more like him. If you've ever felt like an outlier in this field, or like the "right" path just wasn't fitting, this one's for you. Go listen. Then tell me which part landed. — Lindsay CHAPTERS 00:00 The cold open 01:09 Meet Ben Egbers 02:40 From a psychology & German degree to psych NP 03:30 The book that hooked him: "An Unquiet Mind" 05:10 Community mental health, then a pivot to Europe 08:30 The avalanche that changed his path 09:55 Hating med-surg and pharma — the 2am misery 12:50 A $60K pay cut back to bedside psych nursing 14:20 Why he's the "outlier": walking away from private practice 21:00 Networking with therapists (and picking up the phone) 24:50 What he hated most: the billing 25:40 Ten years sober: his recovery story 30:40 Being a provider in recovery, and who's ready for help 34:00 Psychodynamics 101: the unconscious and transference 39:40 The fellowship, and training toward therapy 47:10 What "No Prior Auth" means to him CONNECT WITH BEN Axis Integrated Mental Health — Colorado (deep TMS, ketamine) | https://axismh.com/ 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 #InterventionalPsychiatry #Ketamine #TMS #Recovery #Sobriety #Psychodynamic #MentalHealth

    He Runs Ketamine and TMS — but Wants You on Less Medication

  3. Jun 30

    'The Criticism of NP School Is Sexist' — A Psych NP Fires Back

    Nick Goodwin built one of the more interesting psychiatric practices in the country, and he did it on a shoestring. Eight years ago he opened Goodwin Health Cafe in Spokane with $800 for his DEA license, a free fax tool, and a friend's spare office. Today it's a four-provider practice across two locations, built around treatment-resistant depression — Spravato, TMS, and a space designed to feel nothing like a clinic. He's also the psych NP who writes the psychiatry courses for The Elite Nurse Practitioner, so he's taught thousands of new NPs both the clinical and the business side of this work. And he came on the show to give it all away. We get into the real stuff. How he bootstrapped a practice for almost nothing, and which expenses he'd actually pay for up front. The hiring mistakes that cost him friendships, and the business rule he got from his dad (whose old company inspired the movie Office Space) that he'll never break. His honest read on new grads jumping into private practice, what to do if you're shaky on pharmacology, and the EHR headaches nobody warns you about. Then he says the thing a lot of nurse practitioners have been waiting to hear out loud: the constant dunking on NP education is, in his words, "horrifically sexist." He explains why, and it's worth the listen. If you're building a practice, thinking about it, or just tired of the gatekeeping, this one's a gift. Go listen. Then tell me which part landed. — Lindsay CHAPTERS 00:00 The cold open 01:11 Meet Nick Goodwin & Goodwin Health Cafe 06:24 How he got into psych (his mom and the state hospital) 08:51 Clinical hours vs. running the business 10:49 "The criticism of NP school is sexist" — Nick's take 12:27 What to actually do in your psych NP clinicals 14:43 Opening a practice in 2018 for $800 16:33 The expenses worth paying for on day one 17:08 EHR lessons (and the billing trap to avoid) 18:25 Hiring NPs — and the friendships it cost him 22:00 His dad, "Office Space," and why he'll never take a partner 23:45 Honest advice for new grads going solo 29:33 Becoming the Elite NP psych course creator 31:50 "Get out of here" with the scope-of-practice gatekeeping 39:50 What "No Prior Auth" means to him CONNECT WITH NICK Goodwin Health Cafe — Spokane, WA: https://www.goodwinhealthcafe.com/ Nick's psychiatry & practice courses at The Elite NP: [add the course links Nick is sending] 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 #PrivatePractice #NursePractitioner #Spravato #TMS #MentalHealth #PMHNPlife

    'The Criticism of NP School Is Sexist' — A Psych NP Fires Back

  4. Jun 23

    He Caught Criminals for the Air Force. Now He's a Psych NP.

    Denis Grigorov has reinvented himself more times than most people change jobs. Born in Ukraine, raised in Seattle, he enlisted in the Air Force out of high school, got picked for the Air Force Academy, and became a captain and special agent investigating crimes inside the military. Ten years of service. An MBA. A management job at Amazon. Then he did the thing nobody saw coming — he walked into healthcare. He became an ER nurse at one of the busiest trauma centers in the country, did a full year of psychiatric residency at the VA in Los Angeles, and in January 2026 opened his own practice, D&Y Integrated Psychiatry, named after himself and his wife Yesenia. Four months later, he had 60 clients. This is the private-practice startup conversation I wish every new psych NP could hear. Denis holds nothing back: the VA residency and the $89,000 pay cut he took on purpose, the $4,000 he spent on a "Google expert" who got him zero patients, the EHR he regrets, the legal retainer that was worth it, the collaborating physician he found for $500 a month, and the DEA rule that makes him rent an office one day a month even though he's fully virtual. He also says the quiet part out loud — private practice is not the patients-rain-from-the-sky story some influencers are selling. His Psychology Today bio reads, "You're not broken. You are exhausted from surviving." He's a disabled veteran who now spends his days caring for other veterans, and you can hear why this work found him. If you've ever wondered what it looks like to reinvent yourself five times and land exactly where you belong, this one's for you. CONNECT WITH DENIS D&Y Integrated Psychiatry — Monrovia, CA (TRICARE & VA Community Care) 🌐 https://dyintegratedpsychiatry.com/ 🌐 https://www.linkedin.com/in/denisgrigorov/ 🌐 https://www.psychologytoday.com/us/psychiatrists/denis-grigorov-encino-ca/1681386 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 #PrivatePractice #NursePractitioner #VeteranOwned #MentalHealth #PMHNPlife

    He Caught Criminals for the Air Force. Now He's a Psych NP.

  5. Jun 16

    Traci Spent 30 Years Saving Babies. Then She Had to Save Herself.

    Traci Powell spent almost 30 years as a nurse, most of it in the NICU, holding together the most fragile babies you can imagine. She was the strong one. Straight A's, more degrees, more proof she had it all together. Then at 46 it came apart — a first panic attack, and a depression she'd hidden her whole life that she suddenly couldn't hide anymore. CONNECT WITH TRACI For private clients: https://TheRebuiltWoman.com/ Beyond the Script Society Membership: https://community.beyondthescriptsociety.com/ Beyond the Script LIVE: https://beyondthescriptlive.com/ Free PMHNPs Beyond Meds Facebook group: https://www.facebook.com/share/g/1Dtq92bd4F/ Are you interested in Traci's Radical Restoration Fellowship? https://therebuiltwoman.com/intensive-therapy-for-accelerated-healing/ So she did everything you're told to do. Weekly therapy. EMDR. An SSRI, then another, then another. She got labeled bipolar and treatment-resistant, kept getting worse, and reached the lowest point of her life. The mental health system she would later join as a clinician had failed her as a patient. What finally worked was something almost no one had told her about: the difference between trauma wounds, the bad things that happen to you, and attachment wounds, the good things that should have happened and didn't. Two wounds. Two completely different treatments. Once she understood that, her life changed fast Now Traci practices psychiatry in a way most people have never seen. Three-day trauma intensives instead of years of fifteen-minute med checks. She's trained whole cohorts of psych NPs to do the same, grown a 3,300-member community called PMHNPs Beyond Meds, and is hosting what may be the first national psych NP conference built around therapy and trauma work instead of medication. We get into all of it — the breakdown, the Frozen moment that finally named what she'd been doing her whole life ("conceal, don't feel"), why she calls medication the Tylenol of mental health, her suicide attempt and the hope on the other side of it, and what she'd say to any psych NP who's been told to "stay in your lane.” One line of hers stuck with me: "One person's spoken story is another person's permission to speak."

    Traci Spent 30 Years Saving Babies. Then She Had to Save Herself.

  6. Jun 10

    The Most Recognized Psych NP on the Internet | Dr. Kojo Sarfo

    Links from Dr. Kojo: 1. More to ADHD - ADHD updates straight to your inbox Sign up to receive emails with tips on how to help treat and manage your ADHD. You'll also get access to helpful questions for your doctor and a free resource. - https://www.moretoadhd.com/adult/adhd-information?utm_campaign=MoretoADHD_ADHD_DTC_Adult_Organic-Social-Media_UB_PSY_2025_instagram_influencer_kojo_sarfo&utm_medium=socialinfluencer&utm_source=instagram&utm_content=PSY.2025-0050_UB_MoretoADHD_kojo-sarfo-ig-link-in-bio Dr. Kojo’s Comedy 2026 Tour Dates ⬇️: Boston, MA — July 24th Springfield, MA — July 25th Phoenix, AZ — September 17th San Diego, CA — December 3rd For ticket information 🎟️: https://www.kojosarfo.com/ Dr. Kojo Sarfo has 4.5 million followers, around 150 million views a month, and a confession: the internet pays him more than psychiatry does. He wasn't diagnosed with ADHD until he was 25. He couldn't read until third grade, graduated high school with a 2.7 GPA, and only tried nursing because his dad said his grades wouldn't get him in anywhere else. His parents cleaned buildings in Nashville while putting themselves through school. Two months into a forensic inpatient psych job, he posted his first TikTok — it got three likes, and he didn't post again for two months. Now he might be the most recognized psychiatric nurse practitioner on the planet: a telehealth practice, a clothing line that gives back to Mental Health America, a comedy tour, two podcasts, brand deals with CBS and Hulu, a book with Simon & Schuster, and two trips to the White House. In this one he's honest about the parts most people leave out — which platform actually pays (and where psychiatry lands on the list), what it's like to be a Ghanaian-American man in a field of mostly white women, and the thing nobody films: how lonely it gets when millions know your name and almost no one knows you. Whether you're a psych NP, a student, or you just want to meet the person behind the videos — go watch. Then tell me which part landed. His advice for new psych NPs WHERE TO FIND DR. KOJO [add Kojo's TikTok / Instagram / Facebook / practice / book links] LISTEN TO NO PRIOR AUTH 🎥 YouTube: https://www.youtube.com/playlist?list=PL2xQMQAfCsq3OrVz3RTndA80gfFEFOsez 🍎 Apple: https://podcasts.apple.com/podcast/id1893233469 🎧 Spotify: https://open.spotify.com/show/5tNbJqeMERnglfTHedOhym 🌐 https://psychnpfellowship.com/podcast/ 👥 Community: https://www.skool.com/psych #DrKojo #ADHD #PsychNP #PMHNP #MentalHealth #ADHDinAdults

    The Most Recognized Psych NP on the Internet | Dr. Kojo Sarfo

  7. Jun 2

    Angie Started at 50 with a Credit Card. Two Years Later: 3,000 Patients.

    Angie Janicek worked inpatient psych for 16 years and didn't know psychiatric nurse practitioners existed until 2020. A friend had to tell her. She'd been an RN since 2003, raised four kids (including twins), worked 12-hour shifts, and rotated through military psych units, acute wards, intake, and the ER as a behavioral health assessment nurse. The role she was built for was right in front of her the whole time. She just didn't know it had a name. She went back to school at 45 because her husband had an MBA, her oldest was getting her bachelor's at UT Knoxville, and she realized she was about to have the smallest degree in her own house. That was enough. BSN, then MSN, then DNP from Frontier Nursing University. She opened Premier Psychiatric Services in Goodlettsville, Tennessee in 2024 with her business partner Trey, a credit card, and family members working for free. Her husband John (they've been together since they were 13) managed the books. Trey's wife Brittany quit her respiratory therapy job to answer phones. Nobody got paid for a long time. They hit 1,000 patients in six months. Had to move into a bigger space before their first birthday. They're now past 3,000 patients across a 4,000-square-foot practice, a Spravato clinic for treatment-resistant depression, and a growing ADHD-in-women specialty that Angie is building around the perimenopause and hormonal shift cases nobody else wants to touch. We got into the real numbers: what they spent to open, what they lost on three bad billers before bringing it in-house, why she'd do W-2 over 1099 if she could rewind, the $12-per-chart scribe who changed everything, and why 60% of their referrals come from therapists they visited in person with pamphlets and business cards. She also talked about fighting for NP autonomy in one of the most restricted states in the country and what their senator told them to their faces about why it hasn't passed. If you've been telling yourself you're too far into your career to start over, or too broke to open a practice, or too late to go back to school, Angie went back at 45, opened at 50, and built the thing on a credit card and stubbornness. Her advice is two words: just start.

    Angie Started at 50 with a Credit Card. Two Years Later: 3,000 Patients.

  8. May 26

    Inside Carlat Publishing with Dr. Daniel Carlat; a Detailed Discussion with the GOAT.

    In this special feature, we explore the deep connection between family legacy and the field of psychiatry. The podcast interview offers a unique perspective on the journey into medicine, showcasing a personal story intertwined with professional dedication. The discussion touches upon aspects of mental health and psychology, providing insight into the motivations behind pursuing a career as a doctor. Before Dr. Daniel Carlat built one of the most trusted names in psychiatric education, he was on Wyeth's payroll promoting Effexor. He stopped when the science didn't hold up, wrote a New York Times piece called "Dr. Drug Rep," and spent the next two decades building an alternative — industry-independent CME that psych NPs and psychiatrists could actually trust. In this conversation, Lindsay and Dr. Carlat cover the real story behind his career shift, why he thinks NP education needs structured residencies, what deprescribing looks like when it's done right (not just political), and how his new AI tool, Ask Carlat, pulls clinical answers from 23 years of unbiased content instead of the open internet. He also drops some blunt advice for any NP who's been approached by a drug rep.

    Inside Carlat Publishing with Dr. Daniel Carlat; a Detailed Discussion with the GOAT.
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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. Lindsay Hill is a psychiatric NP and coach helping NPs scale freedom and impact.

Information

  • Creator
    Lindsay Hill, DNP, PMHNP-BC
  • Years Active
    2026
  • Episodes
    14
  • Rating
    Explicit
  • Copyright
    © Lindsay Hill 2026
  • Show Website
    No Prior Auth

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