loader from loading.io

Accepting Insurance and Third-Party Payors In Your Private Practice | TPOT 204

The Practice of Therapy Podcast with Gordon Brewer

Release Date: 11/15/2021

What It Really Takes to Run a Profitable Private Practice | Brandy Mabra | TPOT 431 show art What It Really Takes to Run a Profitable Private Practice | Brandy Mabra | TPOT 431

The Practice of Therapy Podcast with Gordon Brewer

Thinking about starting a private practice in 2026? There’s a lot to consider… and it’s not as simple as it used to be. In this episode of The Practice of Therapy Podcast, I’m joined by Brandy Mabra, who brings nearly two decades of experience across private practice, corporate healthcare, and entrepreneurship. We dig into what’s really happening in the industry right now—from AI and changing business models to profitability and long-term sustainability. If you’re wondering whether now is the right time to start (or grow) a practice, this conversation will help you think more...

info_outline
Why A Lot of Therapists Struggle in Private Practice | Katie Piura | TPOT 430 show art Why A Lot of Therapists Struggle in Private Practice | Katie Piura | TPOT 430

The Practice of Therapy Podcast with Gordon Brewer

Thinking about starting a private practice… but feeling unsure where to begin? In this episode, Katie Piura shares the mindset shifts every therapist needs to make before launching (or growing) a successful practice. From burnout in agency work to building something aligned and sustainable, Katie breaks down the real challenges therapists face and why being a great clinician isn’t always enough. We also get into the business side of private practice that grad school never taught you, including money mindset, marketing, and why asking for help might be the most important step you take. If...

info_outline
How This Simple Method Transforms Private Practice Sessions | Tanya Dantus | TPOT 429 show art How This Simple Method Transforms Private Practice Sessions | Tanya Dantus | TPOT 429

The Practice of Therapy Podcast with Gordon Brewer

What if the thing keeping your clients stuck isn’t what they’re talking about… but what they’re avoiding feeling? In this episode, I’m joined by Tanya Dantus, and we dive into a really practical way of helping clients move through what’s actually underneath the surface. Tanya shares her RIFRA Method, which stands for Root, Impact, Feel, Reflect, and Act, and how this process helps clients stop intellectualizing and start creating real change. We talk about why so many people struggle to access their emotions, how that shows up in therapy, and what it looks like to guide someone...

info_outline
Are Superbills Worth It in Private Practice? | Mark Florian | TPOT 428 show art Are Superbills Worth It in Private Practice? | Mark Florian | TPOT 428

The Practice of Therapy Podcast with Gordon Brewer

Thinking about taking insurance in your private practice or trying to figure out a better way to handle out-of-network clients? This is one of those decisions that almost every therapist wrestles with at some point. On one hand, insurance can help fill your caseload and make therapy more accessible. On the other hand, the admin work, lower reimbursement rates, and constant back and forth can leave you feeling stretched thin and frustrated. In this episode, I’m joined by Mark Florian, founder of Deputy Care, and we get into what is really happening behind the scenes with insurance,...

info_outline
Private Pay vs Insurance: What Therapists Get WRONG | Avivit Fisher | TPOT 427 show art Private Pay vs Insurance: What Therapists Get WRONG | Avivit Fisher | TPOT 427

The Practice of Therapy Podcast with Gordon Brewer

Private pay versus insurance is one of the biggest decisions therapists face, and honestly, it’s also one of the most misunderstood. In this episode, we’re breaking down what therapists often get wrong when thinking about these two models. It’s not just about money or convenience. It’s about how you want to run your practice, who you want to serve, and where you’re willing to spend your time and energy. If you’ve been going back and forth on whether to take insurance, go private pay, or try a hybrid approach, this conversation will help you think about it in a much clearer way....

info_outline
Thoughts on AI and Tech Platforms in Private Practice | TPOT 426 show art Thoughts on AI and Tech Platforms in Private Practice | TPOT 426

The Practice of Therapy Podcast with Gordon Brewer

What happens when you open the floor and let your audience ask anything? That’s exactly what we did in this episode, and the questions did not disappoint. We’re diving into the big ones therapists are quietly asking right now. Is AI going to replace us? Are companies like BetterHelp helping or hurting the field? And how do you actually stand out when clients can talk to a chatbot instead of a human? I’m sharing my honest thoughts on where all of this is headed, what most therapists are getting wrong about AI, and why the human connection in therapy still matters more than ever. If...

info_outline
Helping Clients Navigate Digital Overwhelm in Private Practice | Eli Singer | TPOT 425 show art Helping Clients Navigate Digital Overwhelm in Private Practice | Eli Singer | TPOT 425

The Practice of Therapy Podcast with Gordon Brewer

Most of us know the feeling. You pick up your phone to check one thing and suddenly twenty minutes have disappeared. For many people, this has become a daily pattern, and it is starting to show up more and more in therapy sessions. In this episode, I sit down with Eli Singer to talk about digital overwhelm and the complicated relationship many of us have with our phones and devices. Eli has spent years working in the digital world, including building one of the early social media agencies in North America. After stepping away from that work, he began focusing on helping people develop...

info_outline
How Therapists Can Use Social Media Without Feeling Fake | Jazzmyn Proctor | TPOT 424 show art How Therapists Can Use Social Media Without Feeling Fake | Jazzmyn Proctor | TPOT 424

The Practice of Therapy Podcast with Gordon Brewer

Marketing can feel uncomfortable for a lot of therapists. Most of us were trained to be neutral, private, and to keep the focus on the client. So when someone tells you that you need to show up on social media or talk about your work publicly, it can feel a little strange. But visibility matters more than ever when it comes to building a private practice. In this episode, I’m joined by Jazzmyn Proctor, a therapist, podcaster, and marketing mentor who helps clinicians show up online in ways that feel authentic and sustainable. Jazzmyn shares how she started building her presence while still...

info_outline
Scaling a Private Practice with Intensives, Classes, and Conferences | Dr. Wyatt Fisher | TPOT 423 show art Scaling a Private Practice with Intensives, Classes, and Conferences | Dr. Wyatt Fisher | TPOT 423

The Practice of Therapy Podcast with Gordon Brewer

Couples therapy can be some of the most rewarding work we do as therapists, but it can also be one of the most challenging. Many couples don’t reach out for help until things feel like they’re falling apart. By the time they sit down in your office, there are often years of resentment, hurt, and miscommunication built up beneath the surface. In this episode, I’m joined by Dr. Wyatt Fisher, a psychologist and couples therapist who has spent years refining his approach to helping couples work through those deeper issues. Wyatt shares how his own personal and professional experiences shaped...

info_outline
Doing Couples Therapy as a Husband-and-Wife Team | Kiana & Andrew Joyner | TPOT 422 show art Doing Couples Therapy as a Husband-and-Wife Team | Kiana & Andrew Joyner | TPOT 422

The Practice of Therapy Podcast with Gordon Brewer

If you’ve ever thought about offering couples therapy in your private practice but felt intimidated by the complexity of it, you’re going to love this conversation. In this episode, I’m joined by Kiana and Andrew Joyner, a married duo who run their practice together and specialize in couples work. Kiana is a licensed therapist, and Andrew is a certified professional coach, and together they bring a really unique dynamic into the therapy room. We talk about what it actually looks like to do couples counseling as a husband and wife team, how they divide roles between therapy and coaching,...

info_outline
 
More Episodes

In this episode, I talk about some of the myths and misperceptions people have about being on insurance panels. I delve into this topic and let you know what I've learned about it from my insurance-based practice. First, I speak about the stigma around accepting insurance in private practice. If you accept insurance, you are just as valid and can be just as successful as private practice owners who are cash-based. Tune in as talk about the pros and cons of insurance panels, why I chose to be insurance-based, and where to start when you decide to accept insurance.

The Stigma Around Accepting Insurance In Private Practice

Many people are curious about accepting insurance and if they should or not. There is no correct answer. If you start to delve into your mindset and think about it all, it might just be something that you should consider doing. When you look at all that is out there, there are so many great resources around building a private practice. It seems like most people are encouraging cash-pay. There seems to be a little bit of a stigma against having an insurance-based practice. Many people say that you don't want to be controlled by insurance companies. If therapists don't have a cash-based practice, they're second-class citizens for being an insurance-based practice. I don't agree with that at all! In fact, my success comes from being insurance-based.

The Pros and Cons of Being An Insurance-Based Practice

There are a lot of pros and cons to being on insurance panels. Certainly, one of the cons of being insurance-based is that you've got to have more systems and processes in place. You've got to do more work on the front end to get prepared for insurance. You need specific systems when you start accepting third-party payors and being reimbursed by insurance companies for your services. The biggest con is that there is some work on the front end of being insurance-based.

The pros for being insurance-based are that you've got a built-in referral source by being on insurance panels. I would say at least half the people that we find are from their insurance. In other words, they checked with their insurance provider first to see who would accept their insurance in the area. When making an appointment with us, people ask, how much does it cost? Plus, they ask if we accept insurance. That's why I wanted to be an insurance-based practice. People depend on their insurance, and I want to help those people.

Ready To Accept Insurance? What To Do First

Where do you start? Research your area to find out which are which insurance panels are the most prevalent. In my area, most people have Blue Cross Blue Shield health insurance. Another thing to research is looking at significant employers in the area. Then, check which insurance those companies use. Next, use that data to decide which insurance companies you want to be paneled with. Another thing to note is that when an insurance company offers you a contract, that's negotiable! Make sure to negotiate what rate you will accept.

Systems and Processes Around Filing Insurance Claims

Figure out your systems and your processes around filing insurance claims. If you're on insurance panels, you need a traditional way to send claims off. The best way I know to do that is through an electronic health record system. TherapyNotes helps my practice with this. It's a few clicks of a button to get your insurance claims sent to the insurance companies to be reimbursed. For the most part, insurance companies have a pretty quick turnaround for electronic health claim submissions. Within a week of sending off the claim, we are getting paid. There's a myth that you have to wait a long time to get paid from insurance companies – that's not true! So, make sure you have a way to submit claims and make it as automated as possible.

Cash-Based and Insurance-Based Private Practices

If you're not ready to be entirely reliant on insurance, there's a hybrid option! You can have a mix of cash-paying clients and clients that use insurance. Give people a choice on whether or not they want to pay for therapy through a third-party payor. Remember to set your full fee at a reasonable place; your fee needs to be your FULL fee. The insurance company will pay you what they pay you. Then, you write off the difference between the full fee and the contract rate. If they choose not to use insurance, you can offer a sliding scale based on family income. We don't go and check their income; instead, we go on the honor system. Ensure that the lowest rate on your sliding scale fee schedule is in the ballpark of your average reimbursement rate from insurance companies. If you want more tips about deciding to panel with 3rd-party payors, check out this FREE webinar coming up: https://practiceoftherapy.com/insurancepractice.

 

Being transparent… Some of the resources below use affiliate links which simply means we receive a commission if you purchase using the links, at no extra cost to you. Thanks for using the links!

Resources

Use the promo code "GORDON" to get 2 months of Therapy Notes free.

Blueprint Health: First month free with promo code TPOTPODCAST

Free Webinar | November 19th @ 1 PM EST | Managed Care Finances for Therapy Practice

Apply For My Focus Group [Starts November 2021]

Using Google Workspace As A Practice Platform Course

Get Your Copy of The Full Focus Planner  

Join the Google Workspace for Therapists Users Group

Follow @PracticeofTherapy on Instagram

Meet Gordon Brewer, MEd, LMFT

Gordon is the person behind The Practice of Therapy Podcast & Blog. He is also President and Founder of Kingsport Counseling Associates, PLLC. He is a therapist, consultant, business mentor, trainer, and writer. PLEASE Subscribe to The Practice of Therapy Podcast wherever you listen to it. Follow us on Twitter @therapistlearn, and Pinterest, “Like” us on Facebook.