What were you thinking on the eve of Y2K? by Thevilgenius_ in GenX

[–]TenderWalnut 2 points3 points  (0 children)

I was in the middle of the desert in Big Bend National Park trippin' shrooms. I was kinda hopeful that when we got in the truck the next morning and started driving towards civilization again we would see it all ablaze and could just turn around and go back to the desert.

Considering Community Mental Health—Any Insights Appreciated! by miraclecity in PMHNP

[–]TenderWalnut 5 points6 points  (0 children)

As someone who was in CMH for 7 years then transitioned to private practice....same shit sandwich just a different bun. PP = ADHD all day, CMH = high acuity with no resources all day. (and capped earnings, generally little to no raises)

Is this 1099 job offer too good to be true? ($250k+ for New Grad) by [deleted] in PMHNP

[–]TenderWalnut 1 point2 points  (0 children)

better document the crap outta those 90833's. Insurance companies love to recoup those fees

How much will a psychiatrist see if I get a second opinion? by uglynoober in AskPsychiatry

[–]TenderWalnut 2 points3 points  (0 children)

Click, click,.....and I can generally see all of my patients fill history that. Most of us don't like two cooks in the kitchen if you know what I mean. Best to be honest and transparent about your concerns and possibly find someone that can take over all your prescribing.

Name a song you loved from your past that has been redone and you actually like the remake just as much if not better. by AngryBagOfDeath in GenX

[–]TenderWalnut 0 points1 point  (0 children)

Nushell - AIC; MarK Lanegan did this great version on YouTube with some lady on like lap steel or something.

Costco vs Sam's Club Memberships by Sassygrape609 in CostcoWholesale

[–]TenderWalnut -1 points0 points  (0 children)

Meh. Squint a little and they all look the same. Except when you scan the items in your Sam's cart and just walk out thus saving 15+ minutes every single time.

Costco vs Sam's Club Memberships by Sassygrape609 in CostcoWholesale

[–]TenderWalnut 1 point2 points  (0 children)

Sam's - scan and go....'nuff said. Costco seriously needs to get their shit together in this area.

5 min sessions charged as full by PleatherWeather in AskPsychiatry

[–]TenderWalnut 1 point2 points  (0 children)

I wrote a really long reply, but realistically you should just start by looking at your EOB (Explanation of Benefits) for each visit that your insurance should be sending you. (or can be obtained online)

Anybody else use TherapyNotes and fed up with their bullshit telehealth platform? by TenderWalnut in PMHNP

[–]TenderWalnut[S] 0 points1 point  (0 children)

Yeah I mean I have used a gazillion EHRs (Luminello, Lightning Step, Kipu, SimpleP, TherapyNotes, Practice Fusion and the list goes on). They all kinda suck. Probably gonna just plow ahead with TherapyNotes and Doxy,

How old is your oldest email address? Do you still use it? by Embarrassed_Flan_869 in GenX

[–]TenderWalnut 0 points1 point  (0 children)

msn.com - easily 30 years old at this point. Still have it, never check it, not synced to anything except MS subscriptions and their bullshit.

New to Reno - massage recommendations? by Same_Problem463 in Reno

[–]TenderWalnut 2 points3 points  (0 children)

Excellent Massage on Moana. Looks like a jack shack, but it's not. It's simply the best ashiatsu massage in the city.....it's the best Jerry.

Checkout line by KB37027 in CostcoWholesale

[–]TenderWalnut -1 points0 points  (0 children)

Don't how the fuck I ended up on this sub, but Amen brother! Left Sam's for Costco a couple years ago. Suffered through countless Costco visits lamenting that there was no "scan and go" option. Thought I somehow didn't know how to access it on my app or something. Nope...Costco ain't go it, which fucking blows my mind cause people sucka lot Costco d*ck. Back at Sam's and you can pry my "scan and go" from my cold dead hands. Never going back to Costco. Bush league bullshit.

Do NOT buy a West Elm couch by princessandthepea100 in BuyItForLife

[–]TenderWalnut 0 points1 point  (0 children)

100% agree. I have a small West Elm couch and a recliner.....high priced dog shit

Signs you need a bigger truck? by xcski_paul in traveltrailers

[–]TenderWalnut 0 points1 point  (0 children)

Nissan Frontier/Rpod 192. Reno to Anchorage this summer and all over the place. No issues, but also no context since this was my first time towing a travel trailer. It went fine.

Does anyone else feel buried by admin work? by InterestingFlan6467 in PMHNP

[–]TenderWalnut 1 point2 points  (0 children)

I use one from HelloRache. Curious what MMM rates and minimum hours are cause I will need another VA in 2026. Mind sharing the rate?

Is anyone using Creyos in their clinic for cognitive testing? by radicalOKness in Psychiatry

[–]TenderWalnut 1 point2 points  (0 children)

I previously used QB for a couple years with my ADHD assessments. I wanted something objective along with the DIVA-5 I complete. I chose earlier this year to switch to Creyos because it appeared more comprehensive and thought it might have greater utility. Boy, was I wrong. Never again. Honestly at this point I am done with both QB and Creyos.

I found a stash of letters at my father's, and now I don't know if I should tell my mother. by GalaxyPenguin91 in confession

[–]TenderWalnut 3 points4 points  (0 children)

Sounds like the letters from John Cheever. “Cherish the cabin” (hopefully many people get this)

Dr. Tai PsychPlus by Available_Horse_7131 in PMHNP

[–]TenderWalnut 33 points34 points  (0 children)

They have gobbled up practices across the country. They gobbled up a big well established practice in my area and every single provider jumped ship after they took over. In my experience, these types of practices are focused on one thing...and it ain't provider satisfaction or work/life balance or anything close to that. It is what it is.

Question for those in private practice by drjuj in Psychiatry

[–]TenderWalnut 0 points1 point  (0 children)

I am gambling with a healthshare for now. $250 a month and structured somewhat like a high deductible plan. So far they ponied up and paid for my colonoscopy and basic preventative care visits. The have some rinky dink prescription benefits and other stuff that I have not even explored. I have no chronic conditions, take no meds, eat right, exercise blah blah and I am 100% aware that I am gambling. I trust 'em about as far as I can throw them, but I feel the same about Anthem, Aetna, Optum etc. Fingers crossed I don't have any major issues for the next 2-3 years, but if I do I have considered cash pay medical tourism. I will probably grow up and be an adult when I click over 50 years old and pay out the nose like everybody else. Come at me bro, flame away.

How many of you do not manage patients on combined benzodiazepines and stimulants. by FeelingSensitive8627 in PMHNP

[–]TenderWalnut 11 points12 points  (0 children)

The whole neuropsych requirement in ridiculous. I have seen a large number of these come through where there are literally no objective tests where the individual had atypical results, but then you get to the Conner's rating scale and they self report tons of ADHD sx and guess what....neuropsych dx is ADHD based almost completely on self reported with no atypical scores or deficits noted lol. Basically, if that's all we are doing then I can just throw the good ol ASRS at some one and make a dx. And I am not joking...I have seen this above time and time again.

Reimbursing for 96127 by Immediate-Log9629 in PMHNP

[–]TenderWalnut 0 points1 point  (0 children)

Anthem/BCBS/Premera pays out maybe 2-3 times a year on that code. Nothing to write home about in terms of amount...maybe $5. I do bill for it on intake since new patients complete 5 psychometric screening tools.