When to Say "Yes" to Insurance

Insurance gets a bad rap. And there are plenty of legitimate reasons why... there's the limitation on number of sessions, the disclosure of client information, the limits on pay received and the extra paperwork to complete.

But sooooo many therapists actually do say "yes" to insurance. And while there are some who do it simply to fill up their calendar, there are plenty of others who do this as a conscious choice and as part of their business plan.

And they even feel good about it!

So how do you know if insurance is right for you? There are lots of things to consider. Here are some questions you need to answer before making that decision:

What is the reason you'd like to accept insurance?

You may have heard business coaches talk about being clear on your "Why." When it comes to insurance, I think this is really important. Are you joining a panel because you've heard crickets and want an "easy" referral source? Or perhaps you've been told a private pay practice is unrealistic. Or maybe you've worked with a lot of middle-class working people and want to provide a more affordable option for them. 

Figure out who you want to serve and whether or not being on a panel makes sense with the decision. It will also help you figure out which panels to seek out if choose to say "yes."

How much money do you need per session to make a living?

This is really important. I'm not the person to help you with a business plan but if you haven't created one, you'd better consider this before joining a panel! Many companies pay very little to Master's level clinicians and you need to consider if you can actually afford to accept that fee.

There is some strategy to this, as highlighting your special skills (like speaking another language or specializing in Eating Disorders) can impact your rate and will definitely impact your acceptance. Don't be afraid to negotiate. Think of it as an interview where you're highlighting the very best you can do.

Who will do your billing?

If you've been thinking you would just do all the billing yourself, you may want to reconsider. It's not impossible and some therapists have very little trouble with this. Others have a huge hassle. Unfortunately, there's really no way to tell under which umbrella you'll fall. 

But I will tell you it only takes a couple of denials to make the cost of a billing specialist worth their fee. These are professionals who agree to follow up on claims and denials so you don't have to spend hours on the phone trying to retrieve the $59 you're owed from three months ago. 

Barbara Griswold is the mental health insurance guru and she's put together a list of the best billing specialists. Click here to check it out. 

Will you have a limited number of insurance slots?

Perhaps your "Why" has made it clear to you that you want to accept insurance but your math has shown you that private pay will provide you better work hours. There can be a happy medium. You can choose to only have a limited number of insurance clients. It's just very important you make this clear in your contract and that you stick to this. 

Are you prepared for the documentation?

Most insurance companies actually don't have mounds of paperwork as part of the deal. I swear. However, you do need to be prepared for things like audits and calls from case managers. You need to be on top of your notes and have a clear treatment plan in place for every client.

Be honest with yourself from the outset so that you avoid frustration later on when the insurance company is requesting something you're not prepared to provide. 

Once you've figured out the answers to these questions you should have a pretty clear idea about whether or not insurance is for you. 

Do you accept insurance in your practice? Why or why not? I'd love if you comment below and let us know your own reasons... and lessons you've learned along the way.