4 Steps to Breaking Up with Managed Care

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!

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

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4 Common Business Blunders of Newbie Private Practitioners

"Learn from the mistakes of others. You can't live long enough to make them all yourself."

-Eleanor Roosevelt

When starting out in private practice, there's a lot to know. A lot. The learning curve can be painfully steep, particularly in ways for which we received no official training (finances, hiring practices, etc.). And no matter how knowledgeable or skilled a clinician is, he/she will inevitably take a few wrong steps. And that's okay!

We recently opened up a discussion on our Facebook page to get feedback about common business mistakes that therapists made when they were getting started in private practice. The responses were overwhelming; it seems many of you were eager to reflect on and share lessons that you learned the hard way! Though there were many answers given, a select few kept coming up that are worth addressing. Here are 4 common business mistakes to avoid when starting private practice:

1) Taking Clients Who Are Not Ideal  

Building a clientele from scratch can be daunting, and if you're desperate for business, it might be tempting to take just anyone. But agreeing to see someone who is not your ideal client can be a miserable experience for both you as a therapist and the individual who is paying for professional services. Instead, politely refer to a therapist who is a better fit, continue to market yourself using the REST strategy, and wait for the right clients to come along.

2) Not Hiring a Good Accountant

Many in our group regretted that they hadn't taken on a CPA sooner to handle the finances, bookkeeping, and taxes (especially quarterly ones!). As so many in our Private Practice Toolbox group can attest, it's a worthy investment. One woman explained how she had initially set up her LLC incorrectly and later had to pay thousands of dollars to fix her mistake and get her business running smoothly again. Moral of the story: hiring a skilled accountant may be a bit expensive, but it's absolutely worth it!

3) Insufficient Infrastructure for Unexpected Growth  

For those new to the game, having an influx of clients might sound like a good thing, but the reality is quite different. Having too many clients can cause burnout, being short-staffed, and getting behind on administrative tasks. Don't be afraid to refer potential clients to trusted and reputable colleagues. Making sure your practice is secure and stable will make it so that you can handle the growth over time.

4) Not Understanding Insurance Companies         

Insurance panels are notorious for being confusing and complicated. Enlist a seasoned friend or mentor in your local area to help you navigate the process. Don't wait until you encounter a business emergency or financial crisis to understand all the ins and outs of insurance companies (such as understanding how client health benefits are different from behavioral health benefits). Become as versed and experienced in how to work with them as you possibly can so that you can avoid problems and get properly paid on time.

(I do hope that your goal is to eventually get off of insurance panels altogether and instead adopt a fee-for-service model. Click here to access my webinar about how to do so.)

What mistakes have YOU made that you would advise others against?

What did you learn from them?

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Join my Private Practice Toolbox Facebook group and connect with 3000 therapists around the globe in 2 simple steps: 1) Click request to join the group and 2) Fill out this brief questionnaire before you'll be added to the group.