Most insurance companies require you to terminate your contract with them in writing. Some require as much as 6 months notice in writing. It is critical that you read the fine print in your contracts and abide by them. They will stipulate how you go about terminating your professional relationship with them. Should you wish to do otherwise, you will need to seek the advice of an attorney.

Many therapists who have been insurance-dependent for a while find it easiest to wean themselves off insurance money slowly. I suggest that you begin to terminate contracts based on their reimbursement rates – starting with the lowest and filling those time slots with cash-paying clients. As your income mix stabilizes, you can then terminate with additional companies.

If you have been relying on insurance companies for a significant amount of referrals, you may need to change the way that you market your practice. Hopefully, you are finding lots of info right here to help you attract new cash-paying clients. However, there are also other websites – both therapist and non-therapist focused sites – that can help you grow a strong and vibrant, insurance-free private practice.

If there is anything I can do, Renee, to support you in that transition, I hope you’ll let me know! Leaving managed care behind was the best and most important decision I have made to grow my private practice and build my confidence as a provider! Best wishes to you on your journey!

I’m not an attorney so I am not willing to provide legal advice. Having said that, I can say that what I have been told year after year is that it is unethical and it is illegal to charge clients without insurance one fee and to charge clients with insurance a different fee. I believe it is appropriate to have a written policy on fees that may afford a price break for those clients in financial need. The trick is to define “financial need” and “ability to pay” uniformly across all clients – whether they are paying with insurance or not. To do otherwise, is likely to fall under the category of “insurance fraud.”

It’s also important to recognize that you may not be getting clients for other reasons . . . . Here’s some questions for you to consider before you even start adjusting your fees. Are potential clients actually finding you? If so, how? Once they find you, are they getting the information that they want? Are they booking appointments? Are they showing up for their appointments? Are they returning for follow up appointments?

See what I’m doing here, Yolanda? I’m following the path of your typical client. It’s critical that we identify where you are losing them – assuming they found you in the beginning. Once you know where you are losing them, it’s relatively simple to fix that “leak” and get those clients in the office. Most social workers didn’t get the business training they need to build a strong private practice. Let me know if you need additional information but, whatever you do, don’t throw in the towel too soon.

And, stay tuned for more info that may help you with your website, too!

If $115 is the usual and customary fee in your area, then you should charge that for everyone. And, if you have contracted with managed care for a discounted rate for reimbursement, then you know you will only get paid a fraction of that UCR. But that doesn’t mean you charge less; it just means that you have agreed to accept less.

In fact, I want to suggest that you contact a mental health attorney in your state to ask you how to best go about correcting this practice so that you don’t get into trouble with the insurance companies or your clients down the road. Paying for 15 minutes of good advice over the phone is a good investment in your own risk management. If you do speak with an attorney, I hope you’ll drop back in here to tell us what you learn and which attorney you used.

I was a little confused on the above comment. I charge $115 and ins. companies usually allow between $53-$65. I charge my cash paying clients $65. Is that appropriate? I didn’t think it was fair to charge out of pocket clients $115 and the insurance company doesn’t pay $115.