Webinar: How to 'Break Up' With Managed Care and Build a Fee-For-Service Practice

New webinar this Wednesday on building a fee-for-service private practice

I've written previously about my decisions to 'break up' with managed care and build a fee-for-service only practice. This topic comes up often in my Private Practice Toolbox Facebook Group. Group members often ask questions like:

• Is it really possible for private practitioners to build a cash-pay practice in our current economy?
• How do you find clients who are willing to pay your full fee at each session?
• How do I overcome the fear of losing all of my clientele if I resign from insurance panels?
• How do you address the needs of those in your community who can't afford your services if you don't work with insurance?

If you've ever wondered these questions, you may be interested in my upcoming webinar this Wednesday.

Date: Wed. Oct 10, 2014*

Time: 11:00 a.m. (PT)/Noon (MT)/1:00 p.m. (CT)/2:00 pm (ET)

Length: 90-minutes

*If you can't make the live webinar at that date & time, no problem! You'll receive a link to watch the replay video at your convenience, but you do need to register.

Reserve your seat here

Here's why I resigned from managed care:

• Excessive paperwork: I was spending almost as much time performing unpaid work (paperwork, phone calls, tracking authorizations, and billing) as I was spending seeing clients. I went into this field to do therapy, not paperwork.
• Reduced income: I resented writing off 40-60% of my fee upfront just to be placed on a list with dozens and dozens of other therapists. The managed care companies weren’t doing anything to market my practice, and yet I was being asked to take a huge pay cut to work with their clients.
• Mandatory diagnosing: I grew tired of having to diagnose every client who walked into my office in order to get paid. When I met with a client who didn’t have clearly diagnosable symptoms, I was faced with a dilemma. Do I stretch a diagnosis just so I can get paid, or do I do free therapy because insurance won’t reimburse without a diagnosis?
• Denied or delayed payments: Being denied reimbursement for a variety of reasons and receiving payment weeks or months after I had performed the service was extremely frustrating.

Here's what has happened since 'breaking up' with managed care:

• Exponential growth: My private practice grew from a solo practice to a clinic of 20 providers and 3 locations in a fee-for-service model during an economic downturn.
• Immediate payments: We get paid our full fee at each session (including late cancellations and no shows)
• Streamlined paperwork: We do assessment, case notes, and discharge summary.
• Motivated clientele: We work with clients who value our time and expertise because they are more financially invested in the therapy process.
• Diagnosis has become a tool, not a requirement for payment: We don't have to diagnose anyone.

In this webinar, I'll show you how to:

• Identify and attract your ideal clients.
• Demonstrate the value of your services to your community through building a strong online and media presence so clients will be willing to pay your full fee at each session.
• Wean off of managed care contracts and smooth this transition for your current clients by offering many options.
• Talk confidently about your services, your fees, and financial policies.
• Provide options for potential clients who can not afford your full fee or who want to use their insurance benefits.

The decision to resign from manage care panels and build a fee-for-service practice is not the right path for every practitioner. However, there are some private practitioners who want to go this direction but lack the knowledge, skills, or confidence to implement their desired changes. If you fall into this second group, this webinar is designed for you.

I hope to see you on Wednesday!

Here's the link to reserve your spot for the webinar and access to the replay video

Oh, and if you have any specific questions you'd like me to address in this upcoming webinar, contact me here with "Managed care webinar Q" in the subject line.

Why Some Shrinks Fly Solo

In past posts I've explored the the positives and negatives of joining a group private practice. Now, it's time to focus on the pros and cons of running a solo private mental health practice. When I opened Wasatch Family Therapy nearly 10 years ago, it started out as a solo practice that slowly built over time into a group practice. While I like being "in charge" and autonomous, I'm also an extravert and I highly value my connections with others.

I reached out to other private practice therapists who practice alone to see why they chose to "fly solo."

Autonomy

Florida social worker and healthy eating expert Therapist Karen R. Koenig, LCSW, M.Ed. grew up as an only child, so she's used to being independent and working alone. That autonomy and comfort level has helped her to succeed. “I love being in private practice. I make my own schedule, decide whom I want to see and whom I don’t, set the fee schedule and slide if I want, and get to have an office in my home which makes both life and work easy,” Koenig shares.

Self-expression

Creating an environment that accurately reflects who you are is important to North Carolina therapist Erika Myers, LPC. "Having your own space in which to practice in a way that feels authentic to you, building an individual reputation rather than relying on a group name for recognition,” are reasons why Myers chooses to practice in a solo setting.

Flexibility

Illinois counselor Melanie Dillon, LCPC of Center For Wellness, Inc. practiced independently for 17 years. Of her experience she says, "Private practice gave me a very flexible schedule and autonomy. It also helped me grow to learn all aspects of being a small business owner. It was ideal for parenting and having a second income.” Eventually Dillon developed a mind/body group practice with two chiropractors when she found herself as a single mom and needed to provide a stable income.

As the second oldest of nine children in my family of origin I am used to being "in charge" and in having close connections with others. So, it makes sense that eventually, I grew my own solo practice into a group practice where I am still the sole owner and decision maker. Guess I just can't get away from being the "bossy" older sister.

photo credit: cuatrok77

Poll: Do You Work In A Group Or Solo Practice?

I've recently blogged about the pros and cons of group practice.  Watch next week for more on running a solo practice. Until then, I'm curious how many of you practice in a group practice setting versus a solo practice. Take this poll and please pass it along to colleagues.

Do you practice in a group or solo practice?   (c) Can Stock Photo

Do You Need Permission To Succeed?

As a recent private practice consultation group that I was leading came to an end, we took a few minutes to celebrate the growth and successes of each group member. I asked what each group would take away from their consultation group.  One therapist turned to me and said, "Thank you for giving me the permission to succeed."

I have never really thought about my private practice consulting services as giving colleagues "permission to succeed," but it seemed to fit. I asked myself, "Where did I get the permission to succeed?"

As I thought about it, I realized that my dad had modeled for me personal and professional success. As a child, I watched his music career flourish, how much he was energized through self-expression, and how he was motivated to inspire others through his work. My Dad's modeling taught me that I, too, could create a professional life where I could express myself, be creative when faced with challenges, and inspire to make positive change.

I grew up believing that everyone had permission to have an amazing, creative and fulfilling life. I think that's partly what inspired this blog. I want you to create a thriving private mental health practice that fills you with joy, that works for your life, and that reflects who you are.

When I saw my Dad a few weeks ago, on Father's Day, I made a point of thanking him for giving me permission to succeed. I let him know that I really valued that gift that he'd given to me -- the belief that I could find success and personal fulfillment in my professional life.

Do you need permission to succeed in your private practice?

Permission granted.

Social Media Ethics (part 1): Digital Dual Relationship Dilemmas

photo credit: Eric Schwartzman

I’ve spent months writing about how to effectively use technology, and social media in particular, to build your private mental health practice. While the Internet has opened up exciting new ways for mental health therapists in private practice to market their practice, reach potential clients, and educate the public, it has also allowed for new ethical dilemmas.

When I first started practicing nearly two decades ago, I was concerned about my child being on the same soccer team as a client's child, or about running into clients at parties of mutual friends. The increasing Internet usage by therapists and clients alike has created new opportunities for dual relationships online. Over the coming weeks I'll be discussing ways to use social media ethically in the digital age.

Here are a just few examples of digital dual relationship dilemmas that therapists now face:

• “A former clients sent a ‘friend’ request on my personal Facebook page? Should I accept it?”
• “One of my clients is a friend of one of my family members on Facebook. I don’t want him to have access to my personal information, photos, etc. Is there anything I can do to protect my personal information?”
• “A client just posted a comment on my private practice Facebook page that reveals some clinical information about his symptoms. How should I handle this?”
• “A potential client sent me a direct message on Twitter inquiring about my therapy services. Is Twitter confidential? How should I respond?”
• “During an initial intake with a new client the client shared some grandiose facts about her successful work history and public accolades. Should I Google her name to see if what she’s reporting is true?”
• “I just saw that a client is following me on Pinterest. I’m not sure how I feel about her seeing boards about how I want to decorate my dream house.”
• “Should I enable or disable comments on my private practice website blog? I'm concerned that it may look like I'm encouraging clients to comment on my blog."

I want to hear from you...

Have you faced any of these situations in your clinical practice?

What are some ethical dilemmas you've come across since venturing into social media?

Do you have any specific questions or ethical concerns about the impact of your online activity and it's potential impact on the client-therapist relationship?