5 Steps To Resigning From Insurance Panels

One of the most common questions that private practice therapists ask me is "How do I get off of insurance panels?" This question just came up today in my Private Practice Toolbox Facebook Group so I thought it would be a great topic for a blog post. In previous posts I've written about why I broke up with managed care (part 1) & (part 2), but this post will focus on how to do it.

The thought of letting go of the comfort of being on insurance panels can create a lot of anxiety for private practice therapists. After all, if we don't have clients, we don't get paid. Find comfort in knowing this equation. You only need about half the number of clients in a self-pay practice to make the same income (or more) than you made in an insurance based practice. Once I realized this fact, I felt a lot more comfortable resigning from insurance panels. Let's do the math...

Insurance:

Say you are seeing 20 managed care clients per week and you are reimbursed an average of $70 per client.

20 clients x $70 session = $1,400

20 clients x $70 session x 4 weeks = $5,600 per month

(then subtract your time or money spent in billing and paperwork)

Fee-for-service:

2o clients x $125 = $2500/wk

20 clients x $125 session x 4 weeks = $10,000 per month

10 clients x $125 session x 4 weeks = $5,000 per month

(with NO extra paperwork, NO delay in payment, NO denied claims, NO required diagnosis...)

So often we focus on number of clients instead of the quality of clients and the amount collected per client.

5 Steps To Resigning From Health Insurance Panels

1) Rank the insurance companies

Make a list of insurance panels and rank them from your most favorite to least favorite based on:

• reimbursement rates
• paper work requirements
• how quickly you're paid
• number of clients you see from each panel
• the type of clients generally referred
• your general feeling working with each panel

2) Resign in waves starting with your least favorite

Generally, I recommend to my consulting clients to resign in waves over the course of a year. Resign first from the panels with the lowest ranking - the ones that pay the least and are the most difficult to work with.

3) Check your contract for resignation requirements

Review your contract to check on the resignation process that you agreed to. Look at the time frame required. Do you need to give them 30, 60, or 90 days notice? Do you need to send in a written letter?

4) Beef up your web presence

As part of your plan to resign from insurance panels, it critical to invest in creating other referral sources. The most important being your web presence. Google is my #1 referral source. The majority of our clients who come to my clinic Wasatch Family Therapy find us online. The benefit of clients finding you online is that they've already read about you, your services, and your philosophy on your website and have chosen to contact you. This increases the likelihood that they will be willing to pay your full fee.

• Website - If you don't have a website, make that a top priority. If you have a website, make sure it's effective. Here are some common website mistakes and how to fix them.
• Blog - If you don't have a blog on your site, add one and start blogging weekly.
• Therapist finder sites - join PsychologyToday.com, GoodTherapy.org, and your professional organization's "find a therapist" site to help potential clients find you.

5) Know the benefits of self-pay and be prepared to educate clients

There are benefits to the client for paying out of pocket, instead of going through their insurance company, that they may not be aware of. As you make the transition away from managed care to a fee-for-service practice it's important to familiarize yourself with these benefits so you can educate your clients. A few of those benefits are: control over which provider you choose to work with, the course of treatment decided on by client and therapist instead of insurance company, and no diagnosis requirement.

Here's an example of how a provider educates her patients on the benefits of self-pay. Utah Psychiatrist Kelli Hyland, MD my colleague and consultation client, shares her philosophy in this blog post "Why Self-pay?"

(c) Can Stock Photo

Talking To Clients About Raising Your Fee

Last week I blogged about 5 signs that it's time to raise your fees. Once you've decided to raise your fees, the next steps are notifying your clients about this change, explaining your rationale and preparing to manage your client's varied responses. During my 10 years in private practice I've raised my fees three times. I've also consulted and coached many therapists on how to handle fee raises. Here are a few tips to help you feel more confident talking to clients about increasing your psychotherapy rates.

1) Raise your fees at milestones

I've found that it's easier to tell clients about a fee increase around natural milestones such as the beginning of a new year, the beginning of summer, or the beginning of a new school year. Professional milestones such as a new degree or certification are a also a great time to raise fees.

2) Give clients plenty of notice

I always give clients at least 30 days notice of fee increases to allow them to process their emotions and to plan for the additional expense. I suggest bringing the subject up in a therapy session first and follow up with a written letter. Therapist and private practice consultant Tamara G. Suttle M.Ed., LPC suggests following up your verbal notification with a formal letter indicating the amount and the date the increase will become effective.

3) Raise your fees in waves

I have found it helpful to raise my fees for new clients initially, while keeping current clients at the same rate for an additional 6 months. Existing clients have expressed appreciation for allowing them to remain at the lower rate for an extended period of time and they often find new motivation to work harder and wrap up their therapy before the fee increase goes into effect.

4) Be prepared for a variety of responses

Money is a loaded issue. Be prepared for a variety of emotional responses in your clients and in yourself. Clients may respond angrily, passive aggressively, or they may seem unaffected. It's not uncommon for clients to have a delayed response to your fee change. Notification of fee raises brings up a lot of good clinical "grist for the mill" to process in upcoming sessions.

Do you have any suggestions for handling this delicate topic with clients?

(c) Can Stock Photo