How to choose a collaborating physician service: questions to ask
To choose a collaborating physician service, ask how it matches physicians to your specialty and state, who prepares the agreement, how chart reviews are tracked, what each fee covers and what happens if the fit is wrong. Psychiatric NPs should also ask about controlled-substance oversight and multi-state coverage. Use the questions below to compare any service, including Cosign.
What does a collaborating physician service do?
It introduces NPs and PAs to licensed physicians who will sign a collaborative practice agreement, then handles the paperwork and ongoing tracking. Physicians provide clinical oversight; the service handles matching, agreements and tracking. At Cosign, that means matching by specialty and state, preparing the state-specific agreement and tracking chart reviews and check-ins each month.
How does the service match a physician to your specialty and state?
A good match starts with your state, specialty, prescribing scope and how many charts you see. Ask what the service needs from you, how it vets physicians, and whether you can talk with the physician before anything is signed. Also ask whether the physician holds the licenses your state requires.
Can a psychiatric NP get matched with a psychiatrist?
Ask this first if you are a PMHNP. Psychiatric NPs often prescribe controlled substances and see patients by telehealth across state lines, and a primary care physician may not be comfortable with that risk. Ask whether the service works with psychiatrists who are comfortable overseeing controlled-substance prescribing, and how quickly the physician can respond to an urgent question. See what to look for in a PMHNP collaborating physician.
Who prepares the collaborative practice agreement?
Ask who drafts the agreement and whether it is built for your state. It should cover scope of practice, prescriptive authority, consultation, chart review, meetings and how the agreement ends. Compare any draft with our collaborative practice agreement template, then have counsel review it for your state.
How are chart reviews and check-ins tracked?
Ask how the service records each chart review and meeting, and how you will hear about a missed one. You want a clear record that the work in your agreement is getting done. Cosign tracks chart reviews and check-ins each month.
What does a collaborating physician service cost?
Ask for prices in writing and what each fee covers. Price rises with chart review volume, controlled-substance prescribing, specialty and the number of states involved. Cosign publishes its prices:
| Cosign plan | Price | What it covers |
|---|---|---|
| Match | $750 one time | Introduction, agreement preparation and onboarding |
| Collaboration | $800 to $1,200 per month | Physician time, chart reviews and compliance tracking, with psychiatry at the higher end |
For the factors behind any quote, read what drives collaborating physician cost.
Can one relationship cover several states?
Ask before you sign if you or your group treat patients in more than one state. You may need a collaborating physician in each reduced or restricted state, so ask whether one physician can hold agreements in all of them or whether you need several. Cosign helps groups keep one relationship that covers several states.
What happens if the physician is not the right fit?
Ask whether you can switch physicians and what a switch costs. At Cosign, rematches are free. Also ask what notice the physician will give before ending the agreement, so you can plan a backup in advance.
Which questions should you ask a collaborating physician service?
Bring this checklist to every call:
| Question to ask | Why it matters |
|---|---|
| How do you match physicians to my specialty and state? | The physician should fit your specialty and prescribing scope. |
| Can I talk with the physician before signing? | You can check the fit before you commit. |
| Is the physician comfortable overseeing controlled substances? | Psychiatric NPs often prescribe them. |
| Who prepares the agreement, and is it built for my state? | State law decides what the agreement must include. |
| How are chart reviews and check-ins tracked? | You need a record that reviews and meetings happened. |
| What does each fee cover? | Written prices make options easy to compare. |
| Can one physician cover all my states? | Multi-state practice may need more than one agreement. |
| What happens if the fit is wrong? | You should know your options before you need them. |
Interview at least two physicians before you sign, and put everything in writing. Confirm current rules with your board. General information only, not legal advice.
Frequently asked questions
Does a collaborating physician service practice medicine?
No. Physicians provide clinical oversight. The service handles matching, agreements and tracking.
Can physician assistants use Cosign?
Yes. Cosign works with psychiatric NPs and other NPs and PAs in reduced or restricted practice states, and the telehealth groups that employ them.
What should be in writing before I start?
Everything, including what happens if either side ends the agreement.
How Cosign helps
Cosign matches NPs and PAs, especially psychiatric NPs, with vetted physicians in their specialty, prepares the state-specific agreement and tracks chart reviews each month. Tell us where you practice and we will introduce a physician who fits.
General information only, not legal advice.