Q: What is the best method for determining what to charge for counseling in private practice?
A: Putting a monetary value on what we do in the counseling profession can be difficult. After all, we are caring professionals who want to help first and worry about money second. But if you want to survive and even thrive in private practice, you will need to put a price on your work.
We like to ask the question, "If you had a product that could heal old psychological wounds; help parents and children communicate better; keep a family from breaking up; help someone who is depressed feel that suicide is not their only alternative; diagnose anxiety, depression, obsessive compulsive disorder and thought disorders; or help raise someone’s self-esteem, wouldn’t that product be very valuable?" That product is you. We are some of the most well-trained, experienced, dedicated therapists in the mental health field, and there is nothing wrong with being compensated as such.
Have you been to a doctor, dentist or other medical professional lately? Have you had your car repaired or needed plumbing done in your home recently? I think you see where we are headed here. These service professionals charge fees commensurate with their training, ability and the laws of supply and demand. Counselors can too.
Fees for counseling vary from community to community. Depending on the area, fees can range from $60 to $150 per session or more. There is a concept called "community standard" that affects not only fees but also standards of practice. Simply stated, this means you can ask what other counselors, social workers or psychologists in your area charge. This will give you a range to work from so that your fees aren’t too high or too low for your area.
Positioning your fees somewhere in the upper 50 percent would be a logical starting point. Resist the temptation to "low ball." Setting fees below the community standard will not get you more clients. While fees are one consideration for prospective clients, most are more concerned about your competency and reputation than what you charge.
Q: American Counseling Association members would like to have a "one-stop" place to access managed care links, billing information, website resources, National Provider Index registration and HIPPA compliance information. Can such a resource be developed?
A: Currently you can find direct links to some managed care companies by going to ACA’s website at www.counseling.org, clicking on "Counselors" and then clicking on "Private Practice Pointers." Under "Provider Relations Contact List for Managed Care and Insurance Panels" you will find a few ready links where you can learn more about the company and even apply to be a provider.
This month we will be updating our whole list of insurance and managed care companies, including providing clickable links to their websites so ACA members can apply for providership by having a one-stop place to do so. We are also planning to make links for National Provider Index applications as well as billing and website resources.
Q: I am doing some private practice, and the practice I am with puts clients’ names on the bank deposit slip each day beside the amount showing their payments for services and then takes it to the bank. Is it normal procedure to show clients’ names in this regard?
A: We never put the names of clients on our deposit tickets. There is no need to do that if your office or your accounting software tracks payments. To meet HIPAA guidelines and ensure confidentiality, we recommend you delete client information everywhere it is not essential. Clients should not be able to look at the appointment book. Also, try to have 10 minutes between clients (a "50-minute" hour) if possible and discuss confidentiality with receptionists and your answering service.
The law says that clinicians are in compliance as long as they make reasonable efforts to comply. With this all written in the informed consent document, the therapist should be within compliance guidelines. The wording in our informed consent document (available on ACA’s website under Private Practice Pointers/ Informed Consent) states that the therapist makes every practical effort to protect the confidentiality of the client. That same website has a bulletin on HIPAA compliance as well.
Q: I attended your private practice workshop at the ACA/CCA Convention. I am following up to get information regarding contacts for the national billing services. Thanks for an awesome workshop filled with practical information.
A: Good to hear from you. We don’t give endorsements, but we know Netsource Billing is good. We have had experience with them. The company handles all pre-authorizations, full billing to managed care and insurance companies, follow-up of denials and electronic submission. The company collects from you after you’ve been paid and is HIPAA compliant. The typical charge for a $100 billing would be $8, all inclusive. You can check Netsource Billing out at www.netsourcebilling.com.
Another company we’ve heard of is Therapypartner. You can get more information about this company at www.therapypartner.com.
Robert J. Walsh and Norman C. Dasenbrook are the co-authors of The Complete Guide to Private Practice for Mental Health Professionals (www.counseling-privatepractice.com). ACA members can e-mail their questions to email@example.com and access a series of free bulletins on various private practice topics on the ACA website at www.counseling.org.