Insurance-pay: How Practitioners Gain More Freedom & Growth For Their Practice

Written by Christoffer Nettelbladt on March 31, 2020
Why Practitioners Stop Accepting Insurance
Removing a negative far outweighs adding a positive.
As a therapist you’ve spent a very considerate amount of money, time and energy on the education and perfecting the work to guide clients through their hardships and towards their desired goals.
Opening your very own private practice is where you get to pick the fruits for the seeds you’ve planted throughout education and possible past working experience.
You’ve probably thought about the debate around insurance and whether or not to accept it.
A part of my work with helping therapists & wellness professionals to grow their practice, is talking to several therapists daily for 45 min each where we drill into the details regarding their practice.
“Are you only providing individual sessions or is small groups a part of your service?” 
“What demographics do you typically see?”
“What kind of area are you located in: urban? Suburban? Rural? Telemental?”
“What’s your private-pay rate?” 
“Does your process differ for taking acquiring new clients from stranger to paying client?” 
These are just a few sample questions we work through to get a vivid picture about the situation and how to advance from there.
Now, that is a LOT of discussions with therapists in search for assistance.
Just think how much you learn from speaking with many people in the same situation or field, with similar struggles, visions and desires.
As a practitioner I’m sure you can relate.
Naturally, when I’m speaking to a practitioner, it’s because they need assistance. Their practice isn’t where they would want it to be and they’re in need of help to get there.
A natural part of the process is covering the ongoing struggles. 
While much of what is being shared differs from individual to individual a few topics reoccur over and over again.
The obvious number one being the need for more clients.
However the number two might be less obvious. That’s the widespread and intense frustration the insurance panels are constantly causing, distracting their focus from the main thing, which is their clients results.
Ultimately insurance creates a professional situation where practitioners aren't happy.
“How can I even begin to describe how tired I am of insurance providers.”
That and words to the same effect are being expressed time and time again.
You hear complaints about the different providers at various levels of intensity, and certain patterns emerge. 
While the different providers are being mentioned for different reasons, they are all continuously mentioned.
You know them all to well already:
Although they pop up in different settings and the details vary, they are all ultimately reoccuring in conversations again and again.
“I just don’t feel like I can keep doing this, I never get reimbursed even close to my full rate.”

While worlds like that are a lot to take in they are not even in the same ballpark as tough to hear or speak as:
“By accepting insurance and everything that comes with it, I feel like I’m working for others, even though I got my own practice.”
There are two fundamental issues I see with insurance-pay that’s not the case for private-pay.
The first fundamental problem is that it robs the practitioner the freedom to have their rates representing the complexity of the problem they solve. And whatever higher power you believe in, it knows that it’s complex problems you solve.
The second fundamental problem is that it robs the practitioner the feeling of ownership of their own practice. This go way beyond payment rates and anything like that, this is fundamentally one of the major reasons why anyone would go through all the work of becoming their own practitioner in the first place, instead of handing their CV to someone and get employed there.
As common as these complaints are, why do people still feel the need go through the process of becoming paneled?
What I find is that it comes down to two common fears.
The first is fear of the morality of not accepting insurances.
The second one is fearing that there won't be enough clients to stay afloat without accepting insurance.
From a bird's eye view they both make sense.
Let’s start by looking at the second one, the fear of not getting enough clients without accepting insurance.
Counting in the fact that therapists aren't educated in any field that is essential for creating a thriving practice with clients regularly finding and resonating with them, it make sense why practitioners are fearing this. We all fear what is unknown.
More than that you know that the vast majority of the calls coming in from PT include the straight up question “do you accept ___ insurance?” and more or less end the call right there if you don’t.
In addition to the unknown fields of reliably attracting clients without accepting insurance is the question of morality of the situation.
Enough people won’t be able to afford you if you only accept clients at your private-pay rate, correct?...
...Wrong, IF you have a practice growth process in operation. A refined and dialed in process to your particular needs, at your location, focused around your specific modalities. Then you can have plenty of private-pay clients and referrals.
On average, practitioners have between 20 to 30 weekly sessions at their proper rate as goal.
Even without providing remote help that number of clients only represents 0.0001% of the typical population of the area near the practice. If providing remote sessions, that number become completely irrelevant.
You don’t believe it to be impossible to sustain 20 to 30 weekly clients that’s private-pay in an area with tens-, hundred of thousands or even a million+ for several areas do you?
Let me tell you that not only is it possible, but it happens every week all year around and all of the time.
It’s just a perceived limitation of many practitioners because to them, practice growth and client attraction is still a mystery unless clients show up from insurance or overly crowded listing services.
And so the conclusion is this, you don’t have to put your faith and professional freedom into the hands of insurance panels in order for your practice to grow.
Now if practice growth and client attraction to you translates into:
Signing up for overcrowded listing services.
Print and hand out business cards.
Ask doctors and such for referrals.
Perform excellent work and hope people will hear about it.
Don’t get me wrong performing excellent work is the most important thing, but because of the results of your current clients.
If your growth strategy involves the above then sure, you will need insurance-apy clients for consistency. 
If on the other side your growth strategy involves:
Relevant metrics
Proper market analysis
Proper tracking, both out of financial and marketing purposes
As well as an effective, modern, proven and individualized approach to practice growth utilising the latest tools and techniques that technology has to offer.
Or in other words what we include in the Therapy Practice Consulting approach, then you can and should choose to be private-pay and enjoy your thriving practice free of the headaches and hassles of the average provider.
A practice you preside, NOT the insurance providers. 
Back to the issue that hold people stuck in the broken model on the panels, this illusion of morality – Consider the following for a moment. 
For example purposes, let's say you are aiming at 25 clients a week and you get to 20 motivated, driven weekly clientele paying at full rate. The math on that is likely to land at 2-3 times or beyond the monthly income of that same number of weekly clients if you would “leverage” insurance. 
With no more than those 20 weekly clients, you’re earning way more than you would by “leveraging” insurance (maybe $10,000/mo, maybe $15,000, even $20,000+) and with that, you can afford and have time to take on 5 weekly clients PRO BONO if you should choose to do so.
conclusion, not only is that moral, you’re saving these people from:
The cost of their copay
The cost of any deductibles they might have
The general pain and rumbles of dealing with the panel itself.
Therefore, if you have effective, modern and refined marketing systems in place for you,your practice, and you choose to target private-pay, you can earn more and give back more than ever before. 
If you so choose. The choice is, as always, up to you. Because this is your carrier, your practice and your vision. You are the conductor of this orchestra.

Let Us Help You 2x, 4x or even 10x your private-pay caseload & Grow Your Private Practice Into A Thriving Business. By Teaching You The Methodology & Skills Required
To Grow A Private Thriving Practice In The 21st Century.

Christoffer Nettelbladt

Christoffer Nettelblad helps people start & grow their private practice using online methods while making it simple to understand.
If you're interested in starting your own practice or grow your existing one, then you should definitely reach out and request a free strategy session today.
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