I am in the middle of a saga with Blue Cross Blue Shield right now
(more about that in a later blog))
and it made me think about how grateful I am to be in the position I am
right now AND about the biggest mistake I ever made in private
practice. And because I eventually figured out how to run a rock-solid
private practice through making mistakes and having to
self-correct, I now teach therapists how to skip the mistakes and cut
directly to doing what works. Part of how I teach this is through
sharing my own experiences. So, today, I thought I’d share with you this
huge mistake I made.
Back when I started my private practice, I signed up for every
insurance panel I could find. I figured that if my services were pretty
much paid for, people would have no objections to seeing me as a
therapist. Besides that, I was a semi-experienced therapist and did
solid clinical work. I was right in some ways; potential clients who
called me, pretty much always ended up working with me. But the positive
aspect of being an in-network therapist ended there.
In the end, it turned out that being in-network had far more
drawbacks than positives (and this is being reaffirmed right now as BCBS
of Montana is asking in-network therapists around the state to pay back
significant portions of reimbursements that BCBS issued from July
2013-July 2014, but more on that later). The drawbacks for me of being
in-network were:
- I had no control over what I charged for my services (and when a few
years ago the reimbursement rate DROPPED, in-network therapists had
absolutely no say in the pay-cut they received).
- I could not effectively charge or collect fees for additional
therapeutic services I knew were key to patient progress (i.e.
coordinating care with their other providers, phone support, etc).
- I was sometimes limited by the number of sessions I could have with a client in a calendar year.
- I was always limited on session length (which didn’t work so well if I was doing EMDR with patients).
- It was hard to collect fees for last-minute cancellations or
no-shows, and impossible to collect from Medicaid patients who were my
most frequent no-show clients.
Not to mention that being in-network and listed on insurance websites
did not = adequate marketing. So my actual flow of potential clients
was inadequate to say the least.
But that is all ancient history now since I left the networks almost
three years ago and my business is going better than ever and I think my
clinical work is much stronger now than it was when I was allowing
myself to be told how long sessions could be, how many I could do and
what other services I could offer by people who never went to grad
school to be therapists.
Stay tuned for the details on this crazy saga with big ol’ BCBS.
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