How To Get Clients To Pay Up Front

Aug
18
2011
by Tamara Suttle

Ask Tamara . . .

Sherly Raymond is an LMFT in Bronx, New York who wrote me with the following question.

I have an office policy stating to pay at the beginning ofImage of Red Question Mark each session. My patients don’t follow this policy and at first I did not feel comfortable reinforcing it. I don’t have a receptionist. What are some ways you would recommend that I address this issue with patients?”

It’s Your Rule

Sherly, you are bringing up a common dilemma for therapists.   I, too, require clients to pay for my services at the beginning of our sessions and, when I first started, I also struggled with how to get clients to pay up front.

The problem is not not having a receptionist.  The problem is either you forgetting or being afraid to collect fees up front.  It’s your rule.  Do you have a good reason for it?  If so, you may need to remind yourself what those reasons are.  And, once you are clear that your rule is a good one, here is what you may want to try . . . .

New Clients

The easiest time to train your clients about your office policies is to start the first time you see them.  I say to mine (as we’re walking into the office), “I like to collect fees at the beginning of our sessions.  That way we don’t have to cut our sessions short to deal with money issues.  So, if you want to write your check before you even arrive, we can maximize our time to work together.”

Current Clients

If you have already let your current clients “slip up” and pay at the end of sessions, you’re going to have to re-train them.  It’s simple enough to say “I’m tweaking my office policies and want to begin collecting fees at the beginning of sessions.  That means that when you walk in, the first thing I am going to do is take your payment and write you a receipt. If you want to write your check before you even get here, . . . .”  And, then, of course, you simply pull your receipt out and finish signing it.

This is how I handle collecting fees and, Sherly, I’m confident that this will work for you, too.  Is there anyone who has a different suggestion?  If so, I hope you’ll take a moment to share it with us below.


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How Mental Health Professionals Can Justify Their Clinical Fees

Jul
5
2011
by Tamara Suttle

In the last week, I’ve spoken (or emailed) with four  new professionals who are each struggling to ask for their desired fees.  If you know what the Usual and Customary Fee is for mental health professionals and are still struggling to ask for that fee, then you need to get better at justifying (to yourself and others) why your services are worth that amount.  Here are a few thoughts to help you do just that.Image of Man w Big Brain on Stack of Books

  • According to the US Census Bureau, only  2.1 % of the population in the United States of America has earned a Master’s degree and 1.5 % of the population in the USA has earned a Doctorate.  You are among the most educated in this country.
  • How many years experience do you have in mental health (pre- and post-graduate)?  The more experience you have, the higher fees you can command.
  • Do you have post-graduate certifications in certain areas?
  • How many hours of post-graduate continuing education have you accrued?  The more training and certifications that you acquire, the more justified you will be in asking for a higher fee.
  • Do you have areas of continuing education in which you have accrued 45 or more hours of training?  If so, you can state that you “specialize” in these areas – again allowing you to ask for higher fees.
  • Do you have success stories that you can share to help others see exactly how you were able to help them?
  • Have you considered what it can cost your potential client by not spending $100 / hour?  Think about divorce, DUI’s, poor parenting, and even low self-esteem.  Now talk about those costs.

Take some time to answer these questions and practice dropping this information into your telephone scripts with potential clients – long before you get around to discussing fees.  And, if you still have difficulty asking for what you are worth, consider working with a professional like me to help you resolve those nagging little money issues.

What I know and you need to know is that you deserve to make an honest living helping people change their lives for the better. 


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Filed under: Grow Your Practice, Money Matters, Stress Busters, Time, To-Do's Tagged with , , , ,
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What To Do When It’s Time To Raise Your Fees

May
16
2011
by Tamara Suttle

Once you’ve worked hard to build your Image of Piggy Bank w Blackboardpractice and you’ve been on your own for several years, at some point you are going to need to raise your fees.  (Uh-oh . . . another area that didn’t get talked about in graduate school!)

It’s not a dilemma that you will face often but it is important to know how to handle it when the time comes.  Here’s the steps that I take and the choices I make when it’s time to raise my fees.

Step 1
How much do I need to raise my fees?

I have raised my fees about 10% each time I have raised them.  Whatever your increase, be prepared to justify the amount.

Step 2
Whose fees are going to be raised?

That’s right – you have choices.  Barring any contractual constraints, you may choose to raise the fees only for new clients, for all of your clients, or for only certain hours or types of services (like groups or family therapy).  I have chosen to keep my fees the same for current clients and increase fees just for my new clients.  When a client terminates with me and then returns for services 12 months later, s/he is charged my new (and higher) fee.

Step 3
How should I inform my clients and how much notice should I give them?

Once I decide that I am going to raise my fees, I mention this to my clients at the end of counseling sessions.  I let them know that they will be receiving letters from me that will formally notify them of my intent to raise my fees on a specific date.

It is important to provide ample notice to each of your clients.  I typically give a full 90 days notice in writing.  You may choose to give less notice but I would recommend always giving at least 30 days notice in order to allow your clients ample time to reassess their financial situation, make other financial arrangements, or find another therapist if needed.

Step 4
What’s the result of my change in fees?

After initially mentioning my intent to raise fees and again after mailing the written notice of my intent, I make a point to check in with each of my clients to make sure that they understand why, when, and how much fees will increase.

At the same time, I am also checking out how that fee increase is affecting my client . . . . Is it met with understanding or apprehension or resentment or something else?  The truth is that all of us have lots of emotional baggage related to money.  Therapists do.  And, our clients do, too. Changes in money – plus or minus – typically bring up baggage.

Taking care of yourself – financially, physically, emotionally, spiritually – are what you are ethically required to do.  That means that if you are successful in private practice for the long haul, you will need to raise your fees at some point.  When it comes time to raise your fees, don’t let your money-related baggage get in the way. 

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Before You Reduce Those Fees . . . .

Apr
14
2011
by Tamara Suttle

It may be perfectly alright  . . . and even admirable to reduce your fees to accommodate clients’ financial needs when you are able.  However, before you reduce those fees, take time . . .

  1. To assess your own sense of Little Nerd Boy with Big Glassesvalue and worth.  Make sure it’s not muddying your decisions about fees.
  2. Likewise, don’t be too quick to assume that your client needs a reduced fee . . . they may just need a more flexible payment plan.
  3. Consider ways that you will limit the use of a reduced fee for you client.
  4. And, understand that how you choose to offer / accommodate the need for a reduced fee affects your community’s perception of you and your work.

I’m sure there are other things to take into account when clients have financial needs, but these are the ones that I tripped over when I first went into private practice.   I hope you’ll add to the list by sharing your experiences with reduced fees, sliding scales and the lessons you have learned.

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Ask Tamara – The Logistics Of Changing To A Different Practice Setting

Apr
11
2011
by Tamara Suttle

 

The End - Typewriter

Barbara H. Salkewicz is a Licensed Professional Counselor in private practice with Adults and Children Behavioral Health in Brick, New Jersey.  Earlier this month, Barbara wrote me to share her concerns about working in this insurance based practice and earning less money than she feels she is worth.  She says . . .

The problem I am facing is that I make very little money for a great deal of time invested having roughly 40 clients that I see regularly per week. It is emotionally exhausting and financially unrewarding.

I would like to strike out on my own but do not know the logistics of leaving a practice i.e. changing tax IDs with the insurance companies with which I am paneled, is it ethical to take my client base with me as it is me they want to see and not the practice they have a relationship with, how much notice should I give to find a replacement etc.

I know these are very entry level basic questions but this is something I have not dealt with before and want to handle things responsibly. Any help you can provide would be greatly appreciated. Thanks.”

Barbara, you are wise to be considering these things before you actually leave your current setting.  And, here’s what I’ve been told repeatedly . . . .

Federal Income Tax IDs

Your United States federal income tax ID, also known as your Employee Identification Number,  is a unique identifier assigned to you – not to your employer.  That means that it follows you wherever you go and never changes.

Taking Clients with You

The American Counseling Association’s Code of Ethics indicates that the relationship a client has is with you, the counselor, rather than your employer. That means that you can ethically take your clients with you.  However, if you signed a non-compete clause in your contract with Adults and Children Behavioral Health, you need to run this question by an attorney who specializes in contract law in New Jersey.  You may or may not legally be obligated to leave them behind.  (Check out How to Handle Non-Compete Clauses at Freelance Switch.)

Notice of Resignation

If you have signed a contract or entered into a verbal agreement that dictates a specific timetable or process for ending your current employment, you will need to speak with an attorney before you decide to do otherwise.  However, barring that situation, it is customary to give two weeks notice when submitting your letter of resignation.  Note that this is not necessarily required and extenuating circumstances might warrant a shorter notice.  In any case, you should be aware that your employer also has the right to let you go immediately rather than allow you to work for another two weeks.

Barbara, I hope you’ll let us know when you open your new practice and how we can support you along the way!  Thanks for dropping in to chat here at Private Practice from the Inside Out!

Related Post – You Can’t Just Shut the Door and Walk Away!

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