Insurance vs Cash Pay Private Practice | Pros and Cons of Each
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- Опубліковано 13 гру 2018
- Insurance vs Cash Pay Private Practice | Pros and Cons of Each
FREE Guide: Start a Private Practice in Counseling:
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As promised, today we’re diving in to the pros and cons of being on insurance panels vs only accepting cash pay clients in private practice. In this video I’ll lay it all out so you can feel informed about making a decision as you get started in private practice.
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This video is geared for therapists of all kinds, including psychologists, MFTs, LPCCs, social workers, and others in the clinical counseling field.
Welcome to Private Practice Skills! I’m Dr. Marie Fang, psychologist in private practice. I post videos offering tools I learned the hard way about starting and growing private practice so that you don’t have to.
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This video is not intended as professional or legal advice. Be sure to seek the services of a professional if you are in need of them.
Last week I went into a little bit of a rant sharing my personal experience being on insurance panels. In summary, I didn’t like it. But exclusively accepting private pay clients is no walk in the park either. Let’s break each of these down into their pros and cons:
Insurance:Pros:
Get Busy Quickly
Don’t have to focus on Marketing
Don’t have to focus on Branding
Cons:
Lack of Control. (see whoever calls on your insurance panel)
Pay. (insurance doesn’t pay nearly as much and denies claims)
Wasted Time. (on hold with insurance)
Disrupted Therapy. (denied claims = expensive bill)
Stigmatization. (diagnosis required)
Solutions:
Get specialized training.
Employ someone to bill insurance.
I go into more depth on these pros and cons in last week’s video, so be sure to watch that one to hear more.
Private Pay:
Pros:
Work with clients you want to work with
Work less & get paid more.
Establish yourself as a specialist in your niche (carry influence locally)
Cons:
Marketing (this is a HUGE category - requires lots of business-savvy)
Have to build your brand and know your niche. (This takes work and self reflection in grounding yourself in a vision/passion)
Growth can be slow at first (while you get your name out there)
Solutions:
Get specialized training in business marketing
Make the transition slowly while working another job
It’s important to think through the pros and cons of each of these to decide what might work best for you. For me, the “cons” of private pay play to my strengths well and the cons of insurance were troublesome enough that they drove me crazy. The determining factor for me was realizing that I could see less than 10 clients per week and still earn more than I would seeing 30 or more clients per week on insurance panels. I do offer a sliding scale and see more than 10 per week, but we’ll save that topic for another video :)
I hope you found this video helpful as you decide whether to go through insurance or only accept private pay in your private practice. Be sure to do lots of research on this one - it will pay off later! Until next time, from one therapist to another: I wish you well.
This and several of your other videos have been super informative! Thank you so much for sharing your experiences!
Oh I'm so glad to hear it, that makes me happy!
Another very insightful video! Thanks for sharing!
Thanks again! I appreciate your kind feedback.
Your videos are so helpful, specific, and informative. Thank you!
Oh, my gosh. I am forever thankful for you!! Thanks for the info!
Yaaaas, yay! Comments like these make me so happy! ♥️
Awesome video. Thank you for sharing
Thank you! Very very helpful. Loving these videos I just found yesterday.
Really great videos! High quality content and production. Have you ever considered sharing a video on how you create your video’s?
I actually have one already! You can find it here: ua-cam.com/video/sR8g1rTVeG4/v-deo.html
I’ve experienced all of these cons. The worst is when they get denied but you don’t know about it until months later. Some of my most frustrating moments have been having to tell a client I’ve seen weekly that they thought things were covered but they now owe hundreds if not thousands of dollars. It should be illegal to do this to people. It’s disgusting.
Your videos are so good. Very helpful!
I appreciate the vids even though part two repeated a bunch of part one.
BUT
The need to market is not a pro/con caused by being in-network vs private pay, it's decided by being part of a larger company.
If you're a solo practitioner, you could be on 8 different insurance panels but you still have to market to grow your practice.
Marketing, I think, is also a skill with having anyway because you're always marketing, it's just a question of when and how you do it.
What an interesting experience! When I used to accept insurance, my practice filled within a few weeks. However, I imagine this might really vary depending on where you live. In my area, it's hard to find therapists who accept insurance because it's hard to earn a living wage while billing insurance in the San Francisco bay, so those who accept it fill up quickly.
Regardless, marketing is absolutely a valuable skill!
Love the video! My question is, how do you determine the fee for private pay? My experience with insurance has been awful so I would really like to go with private pay but I'm unsure of where to start.
Great question! You might be interested in checking out my video on setting your rate: ua-cam.com/video/k-ZLSQNk1C8/v-deo.html Ultimately though, you have to go with what works best for you!
I was taking 3 insurances and am now down to 2 insurances. I do see some private pay (about 10% of my caseload), but unfortunately they can only afford to come in every other week or so. The challenge of going private pay is how do you find people who are able and willing to pay a weekly premium fee? (P.S. Love your videos!)
This is such a great question - I love it so much I'm filming a video all about transitioning from insurance to private pay that will go live in the fall! I think the key here is in your marketing strategy. I'd make sure you start by being clear on your niche and seeing if you can position yourself as an expert in a certain specialty. Then focus your energy on marketing to that audience. When people see we're an expert in something, they're more likely to be willing to pay to see us for you. I hope this helps!
Hello, can you do both? Thank you.
Absolutely! Most therapists on insurance panels see cash pay clients as well!
@@PrivatePracticeSkills thank you, I am just starting out. I am so thankful for your help and time.
I am curious about Cash practices -- fee per service or membership pros/cons, and how to set the right rates?
Hello ! Great info as always! Do I need a NPI if I start a Pay cash private practice LLC?
Yes! All providers have one. You can check if you already have one registered here: npiregistry.cms.hhs.gov/ Chances are you are already registered :)
I feel like private pay would be the most beneficial for the therapist but I’ve been around and seen so many people be upset that they can’t afford a therapist unless they take insurance. Unless a therapist provides a sliding scale I feel like so many people that really need help can’t get it simply because they can’t afford it. I understand both sides I just wish there was a way to help those that can’t afford $100+ each session while still making decent money
The therapist I'm going to sublease from only accepts private pay. She said she turned away a lot of clients because she is full and told me that there is a huge demand for therapists in the area. The office is shared with a few other therapists who are part time. My question is, for someone to start out doing part time or 1 day private practice in the beginning, would it be a good idea to start with private pay instead of accepting insurance since I've also thought about the cons you mentioned for the insurance section? I have a full time job so I can't imagine myself dealing with paper work and dealing with some of the issues you mentioned. The therapist said I will have no problem getting referrals because she can refer people to me too (networking). Also I plan to sign up for psychology today - is that a good place for advertising?
This is a great time to be asking these questions. Of course, the decision is completely up to you. I will say that you do have the option of trying out accepting only private pay at first, and if in time you want to then you can apply to join insurance panels.
Either way, it tends to take a bit of time for the insurance application to go through, so you can always start marketing and see what potential clients are asking for as far as insurance vs not!
My experience with Psych Today is it offers a steady stream of referrals, though they aren't necessarily as specific to a particular niche. It's a great tool to get clients calling you so you can navigate in the phone screen if they're a good fit.
Sounds like you have some amazing colleagues that you can refer to and from as well!
Hello Marie,
I wanted to ask If could tell me how you created all your templates for your website and IG post? Do you use Canva?
I don’t have any particular templates on my website. But I do use Canva for my UA-cam thumbnails and I use an app called Over for any text posts for Instagram
Is it not possible to have a niche while accept insurance? If I turn away someone because it is not my specialty (aka I’m not qualified to treat) is that bad?
Another con of accepting insurance is the limitations that insurance companies often set on number of covered sessions per year. Imagine your client having to leave therapy because their insurance company said they were out of covered sessions - when they (and you) know they're still in need of therapy. And that, right there, is why I'm doing private pay only (with a limited number of sliding-scale spaces available).
Could you talk about pros and cons of accepting out of network
Are there grants you can apply for to cover the costs for clients who can’t afford a private pay? Not going through insurance seems to only market to mid-high income families. Since people of low income need services just as much as other income levels and may not even have insurance, how can we see these clients without just doing pro bono work
Considering starting part time private practice but the expenses seem to be quite alot. In one of your videos you talked about how little insurance will pay - how much does Cash pay vs insurance net psychologists per hour?
This is a great question but varies widely depending on insurance panel, location, and of course what rate you decide to charge if you go with charging out of pocket. I would check your local insurance panels first to help give you an idea. I also have a video about the startup costs of part-time private practice that you might find helpful!
I would like to start off by saying that I've watched several of your videos as it pertains to private practice and starting a successful counseling business. There were alot of helpful tools and resources provided.
But as I looked deeper into your methodology and belief system I was truly alarmed. How can someone call themselves a Christian and deny God's very word related to gender identity, confusion and homosexuality. True, everyone deserves to be loved and treated with respect but as Born Again believers we are not to condone or accept sin which is direct disobedience to God. Your platform has brought you notoriety, financial gain, and a voice... why would you use that to lead people in error. There is no such thing as a Progressive or Affirming Christian. God said be in the world and not of the world. Be **transformed** by the renewing of our mines not Conform to societal norms. Understand there will come a day you will have to answer to every idle word and false message that is spread.
I share this in love and respect so that you will repent and come back to the truth. God Bless....
1 Timothy 4:1-2
Now the Spirit speaketh expressly, that in the latter times some shall depart from the faith, giving heed to seducing spirits, and doctrines of devils; speaking lies in hypocrisy; having their conscience seared with a hot iron.
2 Timothy 4:1-4 KJV
I charge thee therefore before God, and the Lord Jesus Christ, who shall judge the quick and the dead at his appearing and his kingdom; preach the word; be instant in season, out of season; reprove, rebuke, exhort with all longsuffering and doctrine. For the time will come when they will not endure sound doctrine; but after their own lusts shall they heap to themselves teachers, having itching ears; and they shall turn away their ears from the truth, and shall be turned unto fables.