breaking up with managed care

10 Reasons to Become a Media-Savvy Therapist

About 8-9 years ago, I felt a pull toward gaining media and social media skills and expertise. At the time, I wasn't sure why...or how. In hindsight, I now see the clear benefits of my media visibility for my private practice and for me as a professional. I also had no idea how fun it would be to build relationships (with producers, journalists, reporters, TV hosts, etc.), educate my community, and share my message and expertise with thousands of people. This decision to become media-savvy has altered the course of my professional life in exciting and new ways. Because my practice has grown so much (3 locations, 20 employees) and requires more management, because I'm increasingly involved in media work and content creation, and because it felt like the right thing to do, I have retired from clinical work. I now focus on writing, private practice business consulting, earning my PhD, and spending time with my family. These opportunities would not have been possible had I not acquired social media skills.

Reflecting on my career (thus far), I want to share with you some tangible benefits of becoming proficient with (social) media and maintaining an online presence. Here are 10 things you can do by becoming a media-savvy therapist:

1) Educate Your Community; Educate The World

The mental health field is by nature a helping profession. We became therapists to help people who are struggling in some aspect of their lives, right? One of the biggest ways to do is this by educating individuals. No matter your area of expertise (marriage therapy, addiction, depression, etc.), you have valuable insight that you can share with your community to serve them and better their lives. By embracing media (TV, radio, print) and newer technologies (blogging, podcasts, social media), your message can be amplified exponentially, causing you to reach a greater audience.

2) Grow Your Practice (even during an economic downturn!

I founded my private practice (Wasatch Family Therapy) in 2002 and consider myself an early adopter of technology. We created a website not long after we opened and have fully embraced and utilized social media as the years have gone by. To say that this has grown our practice is an understatement: maintaining a strong online presence has beenour number one strategy in acquiring new clients. What's more is that we now refer out over half of the individuals who seek our services (click here to read more about how our practice grew even in the economic downturn of 2008).

3) Increase Your Credibility Through Social Proof of Expertise

As you use your platform(s) of choice (blog, Facebook, Google+, etc.) to create content and build your body of work, you will in time gain followers who are interested in what you have to say. This will establish your social relevance and up your credibility. Others now view you as an expert and someone to be trusted. This can open up doors for you professionally, just like it has done for me! (read here about how gaining a social media following has brought me valuable career opportunities).

4) Employ a Fee-for-Service Model 

Because I am familiar to more people, I have been able build a fee-for-service practice. This has led to increased income and has kept my clinicians from having to deal with the stress and burden of insurance companies. A private pay model also helps provide better quality therapy for clients. And once again, it's due in large part to our strong media presence that we were able to "break up with managed care."

5) Raise Visibility For Your Profession 

We as therapists often lament the fact that mental health issues don't receive as much airtime as they deserve (though thankfully, this seems to be changing). Your media skills can help bring these topics to the forefront for your friends, family, and followers. For example, NASW has featured my work in their media news and even invited me to do national webinars. Good media interviews add visibility and educate the public about your profession in general and also about your specific expertise.

6) Create Additional Income Streams (book deals, paid blogging, consulting, etc.) 

There is so much more to being in this field than seeing clients. My online presence has afforded me the opportunities to write for major websites and blogs, consult others about how to best build their practice, and even write a book (currently working on my second one)! By growing your media skills, you too can diversify your professional activities and create multiple streams of income for yourself.

7) Create Content For Your Blog

The information you access through your social media platforms can give you great inspiration for your blog. For example, when I do a TV interview, I then post it on my site, which improves SEO and provides new and engaging content. I've found that because of my technology connections, I never am lacking for material to blog or write about.

8) Reach MORE People With Your Message, Passion, & Expertise 

The power that social media provides to reach others is truly unparalleled. I can now talk with hundreds or thousands of people at one time with each interview, not to mention the many more who will watch, listen, or read it online later. You can infinitely expand your outreach and get your message out there by utilizing media and social technologies.

9) Add Incentive for Additional Clinicians To Join Your Practice 

My media presence and relationships have given other clinicians a reason to work for me instead of opening their own practice. So individuals who potentially may have been my competition are now on my team! Your media presence (blog, interviews, Facebook, etc.) can attract new therapists who know about your vision, values, and niche from what they've seen online.

10) Gain Recognition by Professional Organizations

My media appearances and online presence has garnered the attention of reputable organizations, and I'm grateful to have received some notable accolades. For example, I was named #1 online influencer for depression, and #2 mental health online influencer by ShareCare (a social media health company founded by Dr. Oz, Discovery Communications, and WebMD's Jeff Arnold), and received the 2015 National Association of Social Worker Award for my website JulieHanks.com.

How can YOU improve your media-savviness?

And what great opportunities await you as you do? 

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6 Things I Learned from 'Breaking Up' With Managed Care

6 Lessons Learned From Breaking Up with Managed CareIt was a scary step to resign from all insurance panels! I wasn't aware of any therapists who had built a fee-for-service practice in my area. The things I learned in the process of were better than I had expected. When my practice Wasatch Family Therapy transitioned from managed care panels to a private pay model over a decade ago, I anticipated a few things would happen; I knew that this business decision would help allow me more control over the type and length of therapy, that I would have less paperwork, and I would get paid at the time of service. However, there were some unexpected lessons I learned as well. Here are 6 things I learned from breaking up with managed care:

I Learned:

  •  the value of my perceived value.     

When potential clients learned that I employed a private pay model, they seemed to perceive me as a more competent provider. "You must be really good if you don't have to be on insurance panels." My clinical skills hadn't changed, but my perceived value went up because of how I presented my services. It's surprising how much the way we clinicians value and present ourselves affect how others see us.

  • that I felt more alive in my clinical work.    

The stress of constant paper work and phone calls that was part of being on managed care panels unfortunately led me to resent the work I was doing. However, after transitioning to a private pay model, I could refocus my energy on the reason I went into the mental health profession. Since I no longer felt drained by jumping through hoops for insurance companies, I was able to rediscover my passion and love of doing clinical therapy.

  • that I deserved to be compensated well.

The work we do is vitally important, and it's not selfish to desire income stability for yourself as a mental health professional. Resigning from managed care helped reaffirm to me that I do deserve to be well compensated for my clinical services.

  • that I had more time and energy for family and other passions.   

The income stability, decreased stress, and increased time that a private pay model afforded me meant that I could invest more in my hobbies and in my relationships. I've been able to pursue many of my passions, including songwriting and getting my PhD, and I've cherished the relationships that I've been able to nurture and devote more time to.

  • how to present my fees with confidence.  

Understandably, a mental health professional transitioning from managed care to private pay may feel some hesitation about talking about his/her service fees. I initially felt this reluctance as well. Few people are confident in talking about money! But, as time went on I learned to overcome this challenge and present my fees and talk about a fee-for-service model with ease (click here for more about how to create and assertively implement a financial policy for your clients).

  • how to generously refer to colleagues. 

It can be difficult for many clinicians to refer potential clients to other providers. We may feel somewhat of a scarcity mentality, and that if we don't decide to do therapy work with a certain individual there may not be any other clients who want our services. I realized that even if I didn't see a client for therapy, I could still serve him/her by providing referral options. For example, I could identify sliding scale fee clinics in the area or email names of therapists who were on an insurance panel or were in some way a better fit. By doing this, not only was I helping individuals find the care they needed, but I was also helping other colleagues in my community by providing them with more business. Referring to outside sources has been an incredibly important aspect of working with a fee-for-service practice, as Wasatch Family Therapy currently refers at least 50% of our inquiries to other providers in the community.

timthumbClick here for access to the full webinar "How to Break Up With Managed Care and Build a Thriving Private Pay Model."

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3 Ways Managed Care is Hurting Your Practice

3 Ways Managed Care is hurting your
3 Ways Managed Care is hurting your

This is not the first time you've heard me share my perspective on the problems of building private practice based on managed care. The original intent of these third-party companies was to ensure equity for those who receive treatment, but the actual results have been far from successful and have caused a myriad of problems. Some have even described managed care as the cause of the mental health care crisis. And while managed care wreaks havoc on the field as a whole, this system is also problematic for private therapy practices. As a clinician, I can certainly attest to this. My guess is that you can too. Here are the 3 main ways that using managed care panels may be hurting your practice:

1) Micromanagement of Treatment

Managed care panels have a way of micromanaging you in a supposed attempt to make you accountable. This means that a therapist often has less say and control in the type, length, and modality of treatment provided to the client, who has also has less input in the process. Think about it: an outside, commercial middle-man is dictating how you, the professional, help your client. It's easy to see how such a system lends itself to inadequacy and substandard care.

The mandatory diagnosing of clients is arguably the most deplorable part of using managing care panels. You are often required to provide a diagnosis, even if you do not believe your client has one. Even worse, some companies only accept certain kinds of diagnoses, which only further restricts your ability to provide ethical and accurate information and care.

2) Business Inefficiency

Communicating with managed care companies is a nightmare. There's excessive paperwork to fill out and phone calls to make. The hassle is never-ending, and it takes away from what you want to do: use your professional skills to serve your clients. Not only is your business inefficient and time-consuming to operate, but by looking at the math, you'll discover that your overall costs are increased as well. Even analyzing things solely from a business perspective, it's evident that using managed care is not a desirable model.

3) Payment Problems

When working with managed care their contracted rates were 40-60% of my full fee. Not only was there a low fee, but there was also the frustration of denied or delayed payments. There would sometimes be problems with the paperwork, or things would get lost in the tedious communication, and I wouldn't get paid for weeks or even months. I wasn't being sufficiently compensated for my work, and I wasn't always being paid in a timely manner. It was disheartening to say the least. It is emotionally and financially draining, and we deserve better.

These are three of the major ways managed care can hurt your practice (although there are certainly more). Thankfully, there's a better way. A way you can work less and earn more. I'm excited to share you with in upcoming posts about how transitioning to a fee-for-service model helped me build a thriving practice.

Click here to access my webinar, "Breaking Up With Managed Care" to learn even more tips and strategies.

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4 Steps to Breaking Up with Managed Care

go your own way!

Breaking Up is Hard to Do

We've talked a lot recently about the benefits of switching from using a managed care system to a private pay model. It benefits your clients, it benefits you, and overall it just benefits your practice (click here for a post detailing the math and financial advantage of a self-pay model)! But how exactly do you do it? It's quite a change, so it can be difficult to know where to start. Here are 4 strategies to help you make the transition:

 1) Resign in Waves       

Instead of trying to go cold turkey by leaving your panels at once, pick one or two to begin. I suggest choosing the companies that cause you the most headaches, give you unreasonable hoops to jump through, are infamous for not paying on time, and have the lowest reimbursement rates (most therapists I've consulted have no problem identifying which ones these are). Make the transition by weaning off of managed care panels one at a time.

While you are doing this, you need to be ramping up your REST "marketing" process. This will help you attract full-fee clients. Do them simultaneously to secure future business for your practice.

2) Review Your Contract   

Carefully and meticulously read the details of your contract with the insurance companies. What is the length of time required before resignation? You don't want to get hit with fees or have your transition timeline thrown off because you didn't quite understand your contractual obligations, so do your research and give yourself plenty of time.

3) Write An Official Resignation Letter    

After you've determined the timetable you have, sit down and write your letter to officially resign from the insurance panel(s) you've chosen. Be clear, concise, and professional. No need to go into detail about your reasons for ending your business with a certain company. Firmly express your decision to resign. Also, it's a good idea to follow up to ensure that your letter was received.  

4) Prepare Your Clients

And finally, perhaps the most important step to take in making the transition to a private pay model is to let your clients know. Give them plenty of notice (three months minimum), and present them with a considerate and professional letter that clearly states the upcoming changes. Also, offer them options. If they are close to completing treatment, work with them to finish their sessions before you resign from that particular panel. If your clients desire to stay with you and will be transitioning to paying out of pocket, begin to decrease the length or frequency of their sessions if needs be. It's amazing how some people can turn on the motivation when they have to! You also can educate your clients and encourage them to explore out-of-network benefits. Or you might prepare to transfer clients to a trusted colleague.

When I made the change, my clients were exceptionally understanding. I believe part of this was that I informed them in a confident and considerate way, and I was open to feedback and helping clients process their emotions about it. I was also able to use this experience as a way to model self-care and making difficult decisions. Overall, this was remarkably successful, and the majority of my clients stayed with me!

timthumbClick here for access to the full webinar of all the ins and outs of Breaking Up With Managed Care.

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Tough Love: How to Be Firm About Finances

firm about finances When you decided to go into the field of professional psychotherapy, it's likely that your reasons had little to do with money. Even as you first started, you probably didn't have dollars on the brain all the time (payments, insurance, fees, collections, etc.). Billing specialists deal with that stuff, not us, right? But those of us in private practice quickly discover how important it is to acknowledge and successfully navigate the financial aspect of our businesses. And resigning from managed care panels and switching to a fee-for-service model means that the responsibility to collect fees relies on the individual therapy practice; now, it's our job.

I certainly understand that it can be awkward. People get weird about money. I used to be uncomfortable asking clients for payment after they'd born their souls to me. But thankfully, there's a way to conquer money anxiety, serve your clients, and still meet the needs of your practice and of yourself. Here are some strategies I've discovered about how to be firm about finances and present your stated fees to clients with confidence:

(Re)Consider the Purpose of Money

Your own personal history may lead to your feeling anxiety about money. It may help to rethink the role it plays and the reason why we even have it in the first place: you are offering your time, energy, and skills to therapy, and in return, the client is offering you the resource of money. It's an energy exchange that can be emotionally neutral. It doesn't mean you are greedy or uncaring; not at all!

Value Yourself and Your Services

When I first started, I had a hard time seeing myself as a professional, which meant that I wasn't as confident or assertive about asking for money. But my supervisor helped me understand the training, skills, education, and experience I could offer. Remember what you're worth: you can provide valuable insight to those who are struggling, and you deserve to be compensated for your work. Keeping this in mind will help make it easier to accept payments and communicate about money issues.

Charge Before the Session

It works best to ask for payment at the beginning of the session before attempting to conquer tough emotional issues. This gets it out of the way right away and avoids the potentially awkward exchange at the end. There's no surprise, no uncomfortable conversation about fees owed. There's also something about being paid up front that is gratifying and enforcing for the therapist.

Use a "Money Script"

When possible, it's best to keep a separation between the therapist and the finances because it helps the client not associate his/her counselor with money. Use a planned and rehearsed script to communicate about payments. It may go something like this:

How would you like to pay for your session today?"

When potential clients ask, "Do you work with my insurance company?" I respond, "While we don't bill insurance directly, I'm happy to provide you with a receipt to submit for reimbursement from your insurance company. You may want to check with them and ask if you have out-of-network mental health benefits."

Have a Clearly Stated Payment Policy and Stick to It

Don't skimp on this. Take the time to develop and implement a carefully thought-out policy concerning payments, no-shows, cancellations, etc. By setting clear expectations, you can pave the way for an efficiently run practice with clients who attend sessions and take therapy seriously. Your actions and attitudes about finances will set the tone: if you feel anxious discussing money, your client likely will as well. But if you're professional, positive, and confident, a client will feel at ease.

My clinic policy is that if you are one session behind in payment your therapy is on hold until your account is up to date. Also, we charge full fee for no-shows and late cancellations, even on initial sessions, unless there is an emergency (read here for more about how to get paid for no-shows) . Therapist Leland Clipperton of Counseling & Mediation has a system in place where a client can actually receive a discount by pre-paying for 4 sessions in advance. Do some research, ask around, and get creative and innovative in developing a policy payment or tweaking your existing one.

You may find it helpful to have a system to notify your clients about their upcoming sessions. Making phone calls or using your EHR to send automated text messages or emails a day or two beforehand can serve as important reminders and reinforce the value of therapy. So if they're making the financial investment, we might consider making an extra effort to encourage them to be there.

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In my 12 years in private practice, I've gotten extremely comfortable talking about financial issues with clients. With time, experience, and the use of these strategies, I am confident that the same can be true of you.

 How are YOU firm about finances?

What money tips and strategies that have benefitted your practice can you share?

Click here to access my webinar "How to Break Up With Managed Care" and learn more about how to improve your therapy practice.

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