Early in my career,I naively believed that  the way to build a strong and independent practice was to contract with both insurance and managed care companies.  I spent hours filling out the lengthy applications for each company.  I followed up with phone calls and sent in supportive documentation just trying to get on the companies’ panels as a provider.

"Paperwork" by Luxomedia

Once I was approved to get referrals from the managed care companies, I had more paperwork to do and more phone calls to make. And, did I mention that the fee that I contracted for was significantly reduced from my usual and customary fee?

When counseling was not deemed medically necessary by the Utilization Review professionals, my reimbursement was abruptly cut off.  My clients were unprepared to suddenly be financially responsible for my full fee.  And, neither were they prepared to discontinue treatment with me.

As a therapist in private practice, you have many potentially practice-altering choices to make.  Deciding whether or not to contract with managed care companies is one of them.

Make sure you take the time to consider the implications of working with managed care before you ever contract to do so.

Tags: Choice, Managed Care

"Oriang" by Amin Choc

Andrea from Anchorage, Alaska wrote in . . .

I will be looking for an internship and practicum site in July and I’m not feeling very confident about the process . . . .

Why would an agency want to bother with a student who knows so little and has no experience?”

I get questions like this every semester and thought it might be useful to address this here so that others can read it, too.

Andrea, here’s what I know about why agencies, hospitals, and group practices want  you . . . .

Interns tend to be full of energy, optimism, and enthusiasm. Who wouldn’t want those qualities on site when the staff is likely to deal with addiction, abuse, illness, and death?

Interns see with “fresh” eyes. It is easy after being in the trenches of mental health for a while to become complacent and sloppy.  Teaching  / supervising you helps us stay sharp.

Interns are cost-effective. This is particularly important for non-profit agencies and organizations who survive on a “shoestring” budget.  These agencies often take great pride in being a training ground for new professionals – knowing that you will be lured away to more lucrative positions in a few short years.
Interns are often open to new information and new ways of doing things. Because of this, they are often more malleable to the culture and policies of a new placement – more so than those of us who have done things “our way” for a long period of time.

Interns that excel in their internships and practicums make great employees. Many sites for internships and practicums have a high rate of employee turnover.  If you stand out in your placements, it is likely that you will then become an obvious candidate for those newly opened positions.

If you have been in the position of hiring / supervising interns and practicum student, I hope you’ll drop in here and leave a few words of encouragement and advice to those just beginning their jouney in the mental health professions!

Tags: Internship / Practicum

My oops . . . . I forgot to tell you that I would be co-presenting a workshop, The In’s and Out’s of Private Practice”  with Colorado mental health attorney, Denis Lane, on Friday, February 26th at the request of the Colorado Counseling Association.

My session was called Business Planning for Your Private Practice.  Below are some of the observations made by  participants:

• “I really needed this information and the networking was an added bonus.  Thank you!”
• “Totally worth my traveling 5 hours from Western Nebraska!  Thanks!”
• “Wonderful information shared. Informative.”
• Thank you! This was well worth the effort to attend!”
• “Loved Tamara’s presentation.  Would’ve been happy to hear more / longer.”
• ” Both presenters were extremely knowledgeable and passionate about the topic. It was even better than anticipated!”
• “Tamara was warm and inspiring.  She enabled me to set future goals for my practice.”
• “Tamara was extremely informative!”
• “The most valuable thing Tamara presented, for me was the idea of facing my fears regarding claiming my niche.  Her presentation was a big push towards making a commitment / articulating that.”

Thanks so much to all of you who were able to attend!  You were a terrific group to work with!

And, for those of you who were unable to attend, over the next few weeks I will try to post on some of the most salient points here in my blog so that you, too, can begin to develop (or tweak) a business plan for your private practice.

Tags: Testamonials

Earlier this month, I was asked to speak to a group of new professionals interning at Aurora Mental Health Center.  The topic was on why it’s important to join your state and national professional associations.  Just in case you are hesitating, here are 23 reasons that I believe you should join your professional associations today.

1. This is your number one career development tool.
2. This is how mental health professionals get things done.
3. Often there are special resources available to you.
4. This is where you go to learn how to be a professional.
5. This is how you stay informed about your profession’s standards of practice.
6. This is where you learn about professional trends and mandated changes in practice.
7. This is where you can build relationships and expand your network.
8. This is where you get continuing education at affordable prices via conferences, workshops, and forums.
9. Often those continuing education opportunities include a free breakfast, lunch or dinner.
10. This is how you protect and promote your own profession.
11. This is where you increase others awareness of your practice or your employer’s visibility in the community.
12. Student memberships are often reduced or no fee.
13. There are always opportunities here to give back to / build up your profession by your volunteer efforts within the organization.
14. There are often opportunities for community service.
15. This is where you go to stretch your own thinking and stay creative in your work.
16. This is where you learn what others in your profession are doing.
17. This is where you can easily establish yourself as a leader.
18. This organization may choose to sponsor your work, research, or workshop.
19. Many organizations offer members free listings and links on their websites.
20. This is who negotiates for the best and most affordable liability insurance.
21. This is where you get free advice on ethics issues.
22. Many organizations offer job placement services.
23. This will allow you to know other professionals to consult with and refer to (and vice versa) as your needs dictate.

I’m sure there are more benefits / reasons to join.  Can you tell me why you’ve joined your professional associations?

Tags: Ethics, Insurance, Relationships, Workshop

Erin Blakemore of VOCO Creative wrote a great little post suggesting 10 easy ways to nurture those online relationships you are building.

Whether you call it “do unto others,” “cross-promotion,” or “backscratchin,” the results are the same.  Check out her tips and get busy building your private practice with social media!

Then, drop in here and tell us where we can find you and how it’s working for you.

Tags: Relationships, Social Media

Are you one of those mental health professionals who is constantly coming up with great ideas for therapeutic products but has no idea how to get them developed?  If so, you may want to check out Courage To Change. This online and print catalogue is interested in your ideas for books, workbooks, and games  that address dealing with life challenges at any age.

If you have prior experience with this company or if you decide to pitch an idea to this company, I hope you’ll drop back in and let us know about your experience!

Tags: Pitch Your Idea, Products

offers free training on ”Best Practices in Critical Incident Response in the Workplace – Online.”

If you would like to learn more about this offer, you can do so by clicking here.

Tags: Best Practices, Free

If you market your services via the internet, television, radio, in print or face to face . . . even if you volunteer to man a booth for your community expo . . . you are engaging in direct marketing.  Ken McArthur has just posted new guidelines for direct marketing in the United States.  Tempted to put your head in the sand and ignore the guidelines?  Really??

"Apple Planet" by Jorge Elias

Here are some snippets from Ken’s post:

• Terms like “Free,” “Free Trial,” and “Risk Free” are to be avoided.
• So are potentially misleading offers.
• Don’t offer ‘false sense of urgency’ i.e. “Last Week to Purchase at This Price!” if the offer will continue.
• Endorsements must be honest and accurate depictions of likely use of your services / products.
• Affiliate marketing programs must make concerted effort to track participating marketers and minimize fraud.
• Opt-out procedures need to be written in 12 point font or larger.
• Pre-checked boxes are no longer allowed.
• Billing cycles are regulated.

Other issues addressed include Refund Policies, Up-Selling, Actual Descriptor of Merchants, Fulfillment of Transactions, and Requirements for Customer Service. Check out Ken’s full article, New Credit Card Merchant Account Guidelines for Direct Marketing.

With so much sleaze involved in marketing and online sales, I see this as a giant step in the right direction. What’s you opinion?

Tags: Best Practices, Direct Marketing

When you get ready to close your private practice, for whatever reason, you can’t just shut the door and walk away. Did you know that?  Attorney Richard S. Leslie has written a thoughtful article in the January 2010 issue of the Avoiding Liability Bulletin.  In it he details some of the following for your consideration when you decide to close up shop:

• Ask yourself who needs to be notified – clients, former clients, insurance panels, landlords, supervisees, colleagues and business associates, referral sources, and your licensing boards;
  

  "You Couldn't Have Planned This if You Tried" by Ken Douglas / Today is a Good Day

• Consider the possible circumstances that might result in you closing your door – retirement, geographical relocation, health emergencies, financial circumstances, your own death, your spouse’ or partner’s death,and other unforeseen circumstances;
• Your state may dictate certain actions that you must take when you close your practice;
• Your professional code of ethics and HIPPA will certainly have standards that you must adhere to when closing your practice;
• How to notify existing clients;
• Subsequent maintenance, storage, and access to records;
• How to provide public notice of the closing;
• When and how to notify former clients;
• Why you may not want to terminate liability insurance policies when you close your practice;
• And, in the event of your death or incapacity to handle these things, who does it for you?

Every mental health professional and every professional coach is required to responsibly close their private practice  – regardless of whether their closing is planned or unforeseen.  Whether you’ve been in business for years or you are just now getting started, now is the time to take the steps necessary to prepare for the eventual closure of your practice.

Tags: Closing Your Practice, Ethics, HIPAA, Records & Documentation, Relocation, The Unexpected

"Looking Out" by Tyler Neu / Neuski

According to the American Counseling Association’s Code of Ethics, counselors are not required to diagnose a client if they believe that to do so would cause harm to the client.  Here is an online article in Counseling Today that addresses some of the ways that diagnosing may be harmful to your client.

Tags: Diagnosis, Ethics

Part of what helps you to build a strong private practice  is to become a

"Knots" by Dan Allison

resource for your clients.

Tags: COBRA

Last month I read a post by David P. Diana on the use of trigger points in marketing.

"IMG_2407" by pkdon50

Take a look at his post and then check back in here and let me know what trigger points you’ve found useful in building your practice.

Tags: trigger points

Are you juggling

25 great ideas in your head

all at once

and getting no where with any of them?

If so, my advice to you is to pick one and GO!

It’s easy to get stuck in the middle of gathering ideas, stirring them up and daydreaming about how perfect each one will be . . . and six months later finding that you haven’t moved forward on any of them!

One thing I’ve learned from my writer friends in Boulder Media Women is that if you want to write a book, you have to sit in a chair and write; and, if you want to implement a new project in your private practice, you need to put one foot in front of another to achieve that goal.

It doesn’t happen by itself.  And, it doesn’t happen if you are spread too thin by feeding all your great ideas at once.

Carve out time on a weekly basis dedicated to your one new project.

Block out the time on your calendar.

Set measurable goals for your work.

Develop the idea / product / project.

Finesse the details. (Need a focus group to help?)

Create a marketing plan.

Fill your seats / meet your goals.

Then you’re ready to pick (another) one . . . and GO!

Tags: Goals, Project, Spread Too Thin

A reader,  Kristene Elmore, in Brighton, Colorado wrote in asking,

Can anyone suggest a great billing software to manage a solo private practice?

. . . Does anyone use TheraQuick?

. . . Has anyone customized a general billing software like QuickBooks?”

[Update 01-28-09]    Another reader, Sandy Jardine, in Phoenix, Arizona also wrote in asking for help.

I am a long-time user of Therapist Helper software.  I have just been informed that when I switch to Windows 7 my ancient version of Therapy Helper will be useless.  I need to get new software. I am looking for something SIMPLE.  I have a completely self  pay practice, do no direct billing to insurance, submit no electronic claims and need no scheduler. I provide my clients statements they can submit directly to their insurance for reimbursement.  I also use it for keeping track of my income receivables, client lists, etc.

Can you please recommend what you have found helpful, affordable, simple and windows 7 compatible.”

If you have experience and opinions about billing software, please introduce yourself, tell us what you’ve used (and for how long) and let us benefit from what you know!

Tags: Billing, Software

"The Painting" by Ken Douglas

I was researching on line last week when I ran across Dave Dufour’s blog post of 50 Phrases That Kill Creativity.  It made me wonder . . . .   Which of these phrases keep your business from growing?

Tags: Creativity