(This is the second of a two-part post on terminating your
relationship with insurance and managed care companies.
The first part begins here.)

On Monday, I talked to you about the importance of knowing what you have agreed to in your contracts with insurance and managed care companies  before you begin termination of your professional relationships with them.  Assuming that you have taken those legal commitments into consideration and you still want to terminate those professional relationships, here are the things that you need to do:

• Revise your disclosure statement. You need to make sure that you revise all written documents related to this new policy change concerning fee collection.
• Take into consideration possible exceptions to this new policy. It is possible that you will have some clients who are unable or unwilling to pay your full fee at the time services are rendered. Take time now to consider how you will handle their concerns. Will you be able to offer a reduced fee? Indefinitely? Will you try to wrap up your clinical work early? Or, will you try to transition the client to another equally qualified therapist?  . What you cannot do is simply terminate a clinical relationship because you’ve changed your expectations for payment of fees mid-clinical work with disregard for your clients’ needs.
• Let your clients know in writing the specific date that you intend to end your professional relationship with a specific insurance company. They may want to squeeze in one more session.  I typically give 30-90 days notice in advance of any fee or billing changes.  Think about it.  Many of us wig out about money matters.  Your clients are no exception.  By giving them as much advanced notice as possible, you are giving your clients time to re-prioritize their finances and make new arrangements for covering their expenses.
• Initiate a conversation (or two) with your clients about this anticipated change and what they can expect. In addition to financial concerns, this may also bring up other concerns that need to be dealt with in the office – fears of abandonment, concerns for your own welfare, guilt for having stood you up in the past, etc.
• Let your clients know how that will affect them. I provide receipts for all professional services and expect full payment at the time services are rendered.  On occasion, I will accept a post-dated check and am always willing to discuss my clients’ financial difficulties / concerns.  I will not interact directly with an insurance company concerning clients’ reimbursement but will happily coach a client on what to say and how to increase cooperation from their insurance / managed care company.
• Make sure your client understands. This is about informed consent.  Make sure that your client knows when your relationship with his / her insurance | managed care company will end, how that will affect your client, and how you will handle fee collection and money matters at that point.
• Have your client sign a revised disclosure statement. Make sure that your statement includes when  you discussed this policy change, that your client understands the new expectations, and that s/he agrees to this new policy.

It’s that easy.  And, once you’ve done it, drop back in here to let us know.  I’ll be glad to celebrate with you!