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Presented at the American Counseling Association Conference by Thriveworks. Over 100 slides on building a private practice.
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Thriving in Private Practice2013
Starting and Growing a Counseling Business
Thriving in Private Practice2013
Starting and Growing a Counseling Business
Introduction
Transition: Technician to Entrepreneur
Running a Practice is Not Mostly About Doing Counseling
Is it wise for the average counselor to start a private
practice?
Should I Start/Build a Private Practice?
Reasons NOT to Start a Practice I need/want money now!
I want to keep work separate from my life
I hate business
I want to focus on being a counselor
I don’t want to start from scratch
High Paid Agency Employee
Spread the word
Speak publicly
Make the news
Publish online and off
Build a reputation
Offer specialized services
Help out
Independently Credentialed
The Bootstrapper’s Guide
Make a Commitment
Pay the Price
Focus
Constant Forward Motion
The Bootstrapper’s Guide
Reject Excuses
Build Risk Tolerance
Avoid Non-essential Partners
Track your Progress
Activity One
Risk and Counseling Business
Being an Employee is Risky Too
Failure: Necessary but not Sufficient
Betting the Ranch / Taking a Flyer
Risk Versus Reward
Activity Two
Show me the Money!
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Show me the Money!
According to salary.com, an LPC in Cambridge, MA makes on average $39,778 a year.
Show me the Money!
Insurance: $70 per 45 min. (90801, 90806, 90847)
35 x 48 x 70 = $117,600
That’s 26.25 hours a week of therapy
Show me the Money!
- $490 a month (5%) for marketing = $5880 yearly
$117,600 - $5880 = $111,720.00
Show me the Money!
BIlling is 6% (is $7,056.00)
$111,720.00 - 7,056.00 = $104,664
Show me the Money!
Office: $500 a mo = $6000 yr
Office Supplies = $3000 yr
Professional Dues, insurance, education = $500 yr
Other Misc. = $500 yr
Total = $10,000 yr
Show me the Money!
Final With Medical Billing = $94,664.00
Final without Medical Billing = $101,720.00
Both are a FAR CRY from $39,778!
Show me the Money!
Let’s discuss some variables!
Rumors about Accepting Health Insurance
“I’ve heard I should stay away from health insurance”
“I’ve heard that insurance companies don’t pay well”
“I’ve heard insurance companies are impossible to deal with”
Rumors about Accepting Health Insurance
“I don’t want to be a slave to/employee of the insurance companies”
“I don’t want to do all the additional documentation”
“I don’t want to be told what clients I have to see”
Insurance PanelsGives you Leverage
HMOs More Popular
Universality of HealthCare
Mental Health Parity
Panels Will Close
As my 8-year-old daughter Scoutie says: “You Have GOT to be Kidding Me!?!”
Medical Billing: The Dark Side of Counseling Practice
17 Reasons Your Insurance Claims are Being Denied
1) You waited too long to file the
claim.
2) The insurance company lost the
claim, and then the claim expired.
3) You lacked authorization.
4) The client didn’t acquire a physician
referral.
5) You provided 2 services in 1 day.
6) You ran out of authorized sessions.
7) The authorization timed
out.
8) The client changed his/her insurance plan.
9) The client lost his/her insurance
coverage.
10) The client was late to pay his/her
Cobra.
11) You sent the claim to the wrong
managing company.
12) The provider isn’t paneled with
the insurance company!
13) Services were rendered at the wrong location.
14) The client’s OON benefits differ
from their in-network benefits.
15) The service was already rendered.
16) The client has an out-of-state insurance plan.
17) The client has an unmet
deductible!
Medical Billing Takes Effort
Activity Three
Should I Specialize?
OR...
Finding The Right Identity for Your Practice
Should I Specialize?
Populations Served
Problems Treated
Treatment Methods Used
Business Identity
Should I Specialize? - TIPSDon’t Specialize in Group Therapy
Avoid Creating a Whole Health Program
Consider Demand
Stay Consistent
Be the Best in the World
Can work in a Small Town, Too.
Your Therapy Office
The Bar is Both High and Low!QuickTime™ and a
H.264 decompressorare needed to see this picture.
QuickTime™ and aH.264 decompressor
are needed to see this picture.
QuickTime™ and aH.264 decompressor
are needed to see this picture.
Your Therapy Office
Paint the Pig
Your Therapy Office
Wall Art
Your Therapy OfficeGood Lighting
Your Therapy Office
Music / Better Sound Barriers
Your Therapy OfficeA Nice Place to Sit
Your Therapy OfficeSomething to Read
Your Therapy Office
Cell Phone Charger
WIFI
Your Therapy OfficeRefreshments
Your Therapy OfficeSurprise and Delight
First Impression...(it’s actually NOT your office)
First Impressions...
For many companies, its the person at the counter.
For Counselors, it’s their voicemail :(
Making a Good Impression By Voicemail(yes, voicemail)
Trim the Fat
Smile
Provide Value
Hang up
Um, Write it out
Update Daily
Emergency Instructions?
First Impressions...
Return Calls
Veto Voicemail
Building a Full Caseload: 40 Quick Tips
Ethically Improving Client Retention
Ethically Improving Client Retention
Familiarize clients for a suitable course of treatment
“I let new clients decide how often they come in, and I try not to influence their decision.”
“I think clients know how often they need to see me.”
“It’s unethical to tell clients how often I think they should see me for therapy.”
Ethically Improving Client Retention
Familiarize clients for a suitable course of treatment--Again!
“During the first appointment, I try to convince the clients not to come back.”
“The problem is that clients are ambivalent about whether or not they want to be in counseling.”
“If clients don’t continue treatment, they must not be ready to change.”
Ethically Improving Client Retention
Familiarize clients for a suitable course of treatment--Again! And Again!
“Many clients can be finished with counseling after 5 or 6 sessions.”
“The clients I saw today only needed 1 session.”
Ethically Improving Client Retention
Don’t adopt a strict “disorder-model” approach to care.
“We had little to talk about in therapy this week, which tells me that we must be finished with counseling.”
“When it seems we’re not making progress after a session or two, I suggest clients take a break from counseling.”
Ethically Improving Client Retention
Break the “See You Next Week” Mold
“None of my clients want to see me more than once a week.”
“I’m not a psychoanalyst. I can’t see clients more than once a week.”
Ethically Improving Client Retention
Don’t terminate too early.
“Really?” I said. “Did he buy a ring?”
“Um. No.”
“He proposed?”
“Haha, no. I didn’t think of that. Maybe we’re not done after all.”
Ethically Improving Client Retention
Follow up with Clients who have lost touch.
“I’m worried that a phone call would be a nuisance to my clients.”
“My clients will be ‘creeped out’ if I call them.”
“My client is an adult and should call me if he/she wants to continue seeing me.”
Wrap UpWrap Up
Thriveworks.com/Private-Practice
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