I'm super grateful that I decided to start as self-pay... the reduced fee thing can sometimes be a challenge since I don't like to have a super rigid policy with it, but I sort of go by feel, and when I'm more full I don't take any reduced fee clients unless it's a very special exception. Honestly I don't think I would enjoy private practice nearly as much if I had to play by all the insurance rules/protocols.
I run an insurance practice and was full very quickly (within two months). I am doing the same as you did, contracted with the higher payers and will de-panel over time. In fact, I've already dropped one for just being a PITA. Insurance hasn't been that bad and I have a niche (military) who generally want to use their TriCare.
This is an older video, but it's still good. Add to the cons: If your payor's clearing house gets hacked, you don't get paid for weeks or months until it gets fixed! A major clearinghouse was hacked in February and it still isn't fixed. Filing claims is a nightmare. This was the "strike three" and has caused me to start planning a move out of insurance panels.
Agreed. I am running a hybrid 1 insurance and the rest are self pay. Seems to be working well. Somehow, I am getting more self pay clients than insurance (not complaining). Finding the biggest perk to starting with accepting an insurance or two is it helps build word of mouth. Clients or referral sources say how well you did and then the flood gates start to open.
I do self-pay only in my practice. I started out that way because I had an out of state license so could not contract with insurance just yet, and boy am I glad I did! I'm almost at a full caseload within 10mo and I have YOUR tips to thank! Dove in deep with marketing (my favorite is building personal connections and networking) and now I have a growing client list and several referral sources to pull from! I think the best pro for me, after working way too many years in agency, is not having the "money people" drive my clinical decisions, I get full autonomy to do what I feel is best for my client. Only con I would suggest is being mindful around holidays/vacation season that you may deal with several hiatuses and cancellations which can look scary, but if you plan ahead and match the trends (with your own guilt free vacations!) your wallet will not suffer :).
I have a self-pay practice because I'm just starting out as an ALC. ALC's are not allowed to be paneled with insurance companies. So the only choices are work for an agency (not happening), work in another therapist practice at a reduced fee because of the percentage cut, or start your own practice. I decided on the latter. :)
I started a self pay practice because I really believed it was the right thing to do. However, a year and a half in, I am still nowhere near full and starting to get panicky. I'm a good therapist with training in hypnotherapy, emdr, mental health nutrition, meditation, and a 200YRT. I don't do a sliding scale, but I'm considering starting. However, that is a fear based decision. I expected it to take longer, but not this long. any advice is welcome.
I would wonder about what your marketing efforts have looked like - making sure your clients' other providers know you, setting up coffee dates with other therapists who might refer to you, and looking for speaking opportunities in your city. Those things, and having really good copy on my website and PT profile, have all really helped me!
I totally agree with Valerie! With the kind of training you have Amy, there are TONS of people in your community who need the very thing you provide; it's just a matter of building those solid relationships with referral sources and coming from a place of service. In a future video, I'll give some practical tips on how to network in a way that feels authentic and that actually works. Also, having a killer website can help attract the right kind of clients while repelling everyone else (which is just as important IMO). Thanks for tuning in!
This is a great video! Just got licensed in Florida and planning to start a self pay /cash practice as a mental health counselor. My question is : since I’m not dealing with insurance.. do I need a NPI ? I used to practice in another country and we did not have NPI. Thanks
Google AdWords can definitely be helpful in addition to building authentic relationships with people in your community. In order for Google AdWords to be the most effective, you have to know what you're doing (or hire out) and have an amazing website/landing page to send people to. I've seen therapists build amazing practices without having to spend much $$ on PPC advertising though.
Hey Laura (great name, BTW)! I actually took it a step up and provide courtesy out-of-network billing for any of my clients who wish to use their OON benefits. This way, they don't have to deal with the nonsense of filing themselves. I'll be happy to talk about this in a future video ;)
Great video! I'm self-pay. It really boiled down to I didn't want a boss anymore, which is exactly what insurances companies are.
I'm super grateful that I decided to start as self-pay... the reduced fee thing can sometimes be a challenge since I don't like to have a super rigid policy with it, but I sort of go by feel, and when I'm more full I don't take any reduced fee clients unless it's a very special exception. Honestly I don't think I would enjoy private practice nearly as much if I had to play by all the insurance rules/protocols.
You are so hilarious, wonderful, concise helpful and badass--thanks for your service to all of us!
Wow, thank you!
I run an insurance practice and was full very quickly (within two months). I am doing the same as you did, contracted with the higher payers and will de-panel over time. In fact, I've already dropped one for just being a PITA. Insurance hasn't been that bad and I have a niche (military) who generally want to use their TriCare.
This is an older video, but it's still good. Add to the cons: If your payor's clearing house gets hacked, you don't get paid for weeks or months until it gets fixed! A major clearinghouse was hacked in February and it still isn't fixed. Filing claims is a nightmare. This was the "strike three" and has caused me to start planning a move out of insurance panels.
Agreed. I am running a hybrid 1 insurance and the rest are self pay. Seems to be working well. Somehow, I am getting more self pay clients than insurance (not complaining). Finding the biggest perk to starting with accepting an insurance or two is it helps build word of mouth. Clients or referral sources say how well you did and then the flood gates start to open.
I do self-pay only in my practice. I started out that way because I had an out of state license so could not contract with insurance just yet, and boy am I glad I did! I'm almost at a full caseload within 10mo and I have YOUR tips to thank! Dove in deep with marketing (my favorite is building personal connections and networking) and now I have a growing client list and several referral sources to pull from! I think the best pro for me, after working way too many years in agency, is not having the "money people" drive my clinical decisions, I get full autonomy to do what I feel is best for my client. Only con I would suggest is being mindful around holidays/vacation season that you may deal with several hiatuses and cancellations which can look scary, but if you plan ahead and match the trends (with your own guilt free vacations!) your wallet will not suffer :).
HELL YEAH DANA!!!! I'm so glad you're killing it and that my tips have been so helpful for you! :)
I love your video ;) I just started private practice last month. Only private pay. It has been great ;)
I have a self-pay practice because I'm just starting out as an ALC. ALC's are not allowed to be paneled with insurance companies. So the only choices are work for an agency (not happening), work in another therapist practice at a reduced fee because of the percentage cut, or start your own practice. I decided on the latter. :)
I started a self pay practice because I really believed it was the right thing to do. However, a year and a half in, I am still nowhere near full and starting to get panicky. I'm a good therapist with training in hypnotherapy, emdr, mental health nutrition, meditation, and a 200YRT. I don't do a sliding scale, but I'm considering starting. However, that is a fear based decision. I expected it to take longer, but not this long. any advice is welcome.
I would wonder about what your marketing efforts have looked like - making sure your clients' other providers know you, setting up coffee dates with other therapists who might refer to you, and looking for speaking opportunities in your city. Those things, and having really good copy on my website and PT profile, have all really helped me!
I totally agree with Valerie! With the kind of training you have Amy, there are TONS of people in your community who need the very thing you provide; it's just a matter of building those solid relationships with referral sources and coming from a place of service. In a future video, I'll give some practical tips on how to network in a way that feels authentic and that actually works. Also, having a killer website can help attract the right kind of clients while repelling everyone else (which is just as important IMO). Thanks for tuning in!
This is a great video! Just got licensed in Florida and planning to start a self pay /cash practice as a mental health counselor. My question is : since I’m not dealing with insurance.. do I need a NPI ? I used to practice in another country and we did not have NPI. Thanks
Do you use Google AdWords for your marketing? I have heard that it can sustain a self pay private practice.
Google AdWords can definitely be helpful in addition to building authentic relationships with people in your community. In order for Google AdWords to be the most effective, you have to know what you're doing (or hire out) and have an amazing website/landing page to send people to. I've seen therapists build amazing practices without having to spend much $$ on PPC advertising though.
Does anyone provide SuperBills to their self-pay clients (so they can get reimbursed from their insurance), and do clients find that beneficial?
Hey Laura (great name, BTW)! I actually took it a step up and provide courtesy out-of-network billing for any of my clients who wish to use their OON benefits. This way, they don't have to deal with the nonsense of filing themselves. I'll be happy to talk about this in a future video ;)
Your Badass Therapy Practice yesss please create a video on this!!!