There are lots of things we never learned in grad school. Lots of really basic things you need to do every day if you own a private practice! And one of those things is dealing with administrative paperwork so it stays organized and doesn't take up all your clinical time.
If you've read any of my other blogs you know my big "schtick" is making your documentation meaningful. I find making that connection with paperwork eases a lot of the anxiety counselors commonly feel. However, sometimes you just need tips on making things more efficient so it's not as time consuming. And that's what we're talking about today!
1. Have clients complete paperwork ahead of time.
There are a variety of ways to do this but having clients spend some time reviewing your forms, policies and maybe even completing an assessment form before first talking with you will allow you both to focus on what is most important in that first session.
If you use an EHR, you may allow clients to log into a client portal and easily complete forms and sign paperwork that way. Or perhaps you email clients a welcome packet, along with directions to the office and an appointment time confirmation before each session. You can also have forms available for download/viewing on your website and direct clients there. Lastly, you can even tell clients to arrive early and simply have paper forms waiting for them to complete.
Regardless of which method you use, I recommend sitting down and completing your forms yourself, as if you were a client. Complete them to the best of your ability and time yourself. How long should clients allow to complete this task? Now you have a realistic idea and can let them know what to expect. This little customer service step can make a big difference.
2. Review forms with your clients in person.
Even when you have clients complete forms ahead of time there are certain things you need to review in a personal conversation. You’ll want to make sure you review things like limits to confidentiality, fees, risks and benefits of therapy, getting a hold of you in emergencies, no show and cancellation policies, etc.
Keep your forms visually friendly in order to aid this process in moving along quickly and easily. Use titles and bullet points so you can highlight the key points and make sure your client understands each item. Then you can easily “sign off” together (if you haven’t already done so electronically).
Remember that all of these things are actually an ongoing conversation with your clients. You’ll likely need to revisit certain things at different times and you don’t have to cover everything in the first session. Many counselors use the first 2-4 session as an “intake period.”
3. Do your assessment form via conversation.
Perhaps you prefer to do your assessment form together with your client. Awesome! This is another great strategy for getting paperwork done in a timely way while also connecting it to the clinical work. Make sure you know your forms well and can easily flip through pages based on how the initial conversation is going. There is nothing worse than someone stopping you mid-thought to go off an interview script.
So be flexible and let your client choose the direction while you complete some of your paperwork. Ask questions as needed and keep things focused on how you can help the client. There may be some things you need to ask that are not voluntarily brought up by the client (history of substance use, for example). Gently explain your purpose for the assessment period and the fact that you understand some things may initially be uncomfortable but honesty will benefit the therapeutic relationship.
Explain that you’ll be taking notes and value their input along the way. I find most clients are very understanding when completing forms like this when they are part of a natural conversation.
1. Use an electronic health record (EHR)
There are few steps you can take to improve your organization in private practice as much as using an EHR. Also called practice management systems, these provide a one stop shop for notes, treatment planning, scheduling, billing, securing client data, etc. Yes, it takes a little time to set up and get used to whatever system you choose but it is well worth the time investment for most therapists.
There are many EHR’s out there and if you’re confused about where to start I recommend checking out Tame Your Practice, where you can find reviews on just about every system out there and make the best decision for your needs. Also, make sure to bookmark my guest post where I review Tips for Transitioning from Paper to Private Practice EHR.
2. Use a billing expert.
It only takes one “bad” claim to eat up three hours of your day. That’s why most counselors just ignore these claims entirely and choose to take a loss- the money they’d earn isn’t worth all the time it takes to retrieve it. However, if you use a billing service you can avoid all that hassle.
Yes, they will take a percentage of each claim you bill but considering the incredible stress claims put on most therapists, it is worth every penny. Shop around and make sure you choose someone who specializes in mental health billing. Try them out for a period of time to make sure everything is working. You can also check out Barbara Griswold’s Billing Service List, which is a list of national billing services rated by other therapists.
3. Integrate your calendars.
Lastly, integrate your calendars and scheduling tools as much as possible. Especially in the beginning of starting a private practice, many counselors have clients on random days and times because they have more availability. This can easily get out of hand as you become more busy and keeping everything in your head is a sure way to make a mistake in the future.
4. Alphabetize everything.
When you only have 2-3 clients it’s fairly easy to keep track of everything… not so when you have 20-30! And it is very easy to experience overwhelm once those numbers start to rise and you realize keeping track of everything has become more complicated.
Even if you use an EHR there will always be some things you’re likely keeping in a file cabinet or housed on your computer and these should be organized so you can easily find them. Start now by alphabetizing everything- business and networking contacts, CE certificates, client information, etc. For things like taxes or other financial statements, organize by year and month (maybe weekly if you have a larger practice).
Then you’ll easily be able to file things away and find things later on. Little tasks like this are huge for decreasing overall stress and avoiding big mistakes.
If all these tips feel a bit overwhelming, choose one and start from there. No one taught you this stuff and there is a lot to figure out for yourself. One of the biggest mistakes I see many therapists make is trying to do what a supervisor or colleague did when it doesn’t work as well for them. Test things out and adjust as needed.
Find that you hate using an EHR? Ditch it and go back to paper! In that particular circumstance I’d recommend giving it a good try first, but seriously… do what works for you, your business, your clients.
Now let us know in the comments what organizational tools help you with paperwork the most? How do you save time on administrative tasks? I’d love to hear about it!
Like the tips in this blog post? This blog is part of the compiled tips in the ebook Workflow Therapy: Time Management and Simple Systems for Counselors.