Found a Collaborating Physician? Setting Up Is Easier Than You Think

Here’s what comes next—and what you’ll need to have in place before you start working together.

If you’ve never set up your own collaborating physician relationship before, the process can sound more complicated than it actually is.

The good news is that once you break it down, there are really just a handful of things to take care of. The exact requirements vary by state, but in most cases you’ll need to understand your state’s rules, put the appropriate agreement in place, address malpractice coverage, and establish how you and your physician will work together.

Here’s where to start.

1. Find out exactly what your state requires

There isn’t one set of collaboration requirements that applies to every NP.

Depending on your state, there may be requirements involving a written collaborative or supervisory agreement, physician availability, periodic meetings, chart review, prescribing, documentation, or other aspects of the relationship.

Start with your state Board of Nursing. Depending on the state, you may also need to check requirements from the medical board or another regulatory agency.

The key is to look at the actual requirements for your state rather than assuming that the arrangement another NP uses will work for you.

2. Get your collaborative agreement in place

If your state requires a written collaborative agreement, you’ll need an agreement that meets those requirements.

But you probably don't need to create one from scratch.

Some state boards provide sample agreements, templates, or guidance online. Your state NP professional organization may also have sample agreements available to members or for purchase.

In addition to anything required by your state, your agreement can address practical details of the relationship, such as communication, consultation, compensation, termination, and other expectations you and the physician agree upon.

For more complicated arrangements—or if you're simply more comfortable having another set of eyes on it—you can also have a healthcare attorney review the agreement before signing.

3. Check your malpractice coverage

Depending on the arrangement you have with your collaborating physician, your physician may need to be added to your policy as an additional insured. If that's necessary and your current malpractice carrier doesn't allow it, you may need to switch to a carrier that does.

That may sound like a bigger hassle than it actually is. If you've already paid your malpractice premium for the year, ask your current insurer about cancellation and whether you're eligible for a prorated refund of the unused premium (you usually can be refunded the balance).

4. Decide how you'll work together

Once the regulatory pieces are clear, you and the physician can establish how the relationship will work in everyday practice.

Your state may dictate some of this. For example, there may be requirements regarding how frequently you meet, physician availability, chart review, prescribing requirements, or special documentation rules.

If chart reviews are required, determine how many charts need to be reviewed, how frequently they'll be reviewed, and how the reviews will be documented. Some NPs securely fax records for review to their collaborating physician (Doximity is great for this and offers you a free HIPAA compliant fax), others give access to their EHR to the collaborating physician. 

If regular contact is required, decide how and when that will occur.

You should also discuss how you'll reach the physician when you need consultation and what happens if the physician is temporarily unavailable.

Once you've established a routine, these things generally become just another part of running your practice.

5. Complete any required state paperwork

Depending on your state, signing the collaborative agreement may not be the final step.

You may need to register the relationship, submit an agreement or notice, identify your collaborating physician to the Board of Nursing, or complete another filing before the relationship becomes effective.

The physician may have a filing requirement with the medical board as well.

Check both sides of the relationship so you know everything that needs to be completed—and when it needs to be completed—before you begin practicing under the arrangement. 

6. Keep your collaboration records organized

Once everything is established, create one place to keep your collaboration documents.

That might include your signed agreement, amendments, proof of malpractice coverage, state filings or confirmations, and documentation of any meetings or chart reviews required by your state.

You don't need an elaborate system. You just want to be able to easily show that you're meeting the requirements of your agreement and your state.

It really can be this straightforward

Setting up your own collaborative relationship can seem intimidating when you've never done it before. But once you break the process into steps, it becomes much more manageable:

Know your state requirements → Put the agreement in place → Confirm insurance → Establish your routine → Complete any required filings.

And once those pieces are established, you're not continually “setting up collaboration.” You're simply maintaining an ongoing professional relationship with your collaborating physician.

There's another advantage to establishing the relationship yourself: you get to decide who you want to work with.

That's one of the reasons we created Collab-MD.

Instead of being assigned a physician, you can explore physicians who are actively open to NP collaboration, compare your options, and decide who you want to contact. Once you've connected, the relationship belongs to you and the physician.

Collab-MD doesn't dictate the terms of your collaboration, collect a percentage of what you pay your physician, or get in the middle of your business.

Browse. Compare. Connect. You choose.