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Are you a cash-pay therapist? Do you want to bridge the gap between clients needing therapy without you taking insurance and losing money? How can you tap into the out-of-network benefits and still be cash-paid?
In this podcast episode, Joe Sanok speaks about how to bill out-of-network benefits with Christine Li (and exactly what to say when someone asks “Do you take my insurance?”!)
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Meet Christine Li
Christine Li is the founder and CEO of Mentaya. Their mission is to increase access to high-quality mental health care in a sustainable way. At Mentaya they believe that the solution to greater mental health access has to include helping therapists put their oxygen masks on first.
Christine was a former product manager at Google and has a degree in computer science from Princeton.
Visit Mentaya, and connect with Christine on Twitter and LinkedIn.
FREEBIE: Sign up to Mentaya with the code JOE to try the Instant Benefits Calculator for free for a month!
In this Podcast
- Why out-of-network benefits?
- The problems with insurance
- Are you a private pay therapist?
- What to say to a client
- Christine’s advice to private practitioners
Why out-of-network benefits?
Christine’s passion to start a business came from her desire to make high-quality mental health care more accessible. Her company was initially focused on out-of-network benefits because they wanted to ensure that they were taking both the client and the perspective into account.
I know that this is a field in which mental health workers and therapists are oftentimes or are not as focused on [since] it’s a lot on the client … We wanted to do it in a way that would not only help the client but also help the therapist as well. (Christine Li)
Working with out-of-network benefits is then a great way to help the therapists get their full hourly rate while allowing clients to be reimbursed for up to 80% of the cost of that therapy.
The problems with insurance
With insurance, a lot depends on the contract and the practice’s physical geographic location because for some locations insurance companies will pay more than others. This can become tricky if the cost of living in an area is especially high, which could end up costing a therapist more money than they are able to make by working with a certain insurance company.
A lot of therapists find it unsustainable to only take insurance clients and so most therapists are either entirely out of network or have a big chunk of their practice that is out of [insurance] network. (Christine Li)
If a therapist is considering taking on insurance, they will have to consider whether they have time to handle the billing that comes with being in network, consider the practice’s accessibility to clients, and how much they would be paid at the end of the day.
Are you a private pay therapist?
Most clients might not realize that they have out-of-network benefits, and if they see you even as a private pay client, they can still get reimbursed from their insurance company for their therapy with you.
You don’t have to specifically be credentialed, but you might need to be registered as an out-of-network provider with the insurance company.
What to say to a client
I think one of the most difficult things about going cash pay or being out of network is saying to clients, “Hey, this is the fee. Sorry, we don’t take insurance. Here’s a superbill, good luck submitting!” … There are other ways to do that, and to have that conversation. (Christine Li)
With a platform like Mentaya and its benefits calculator, you could be a cash-pay therapist but then say on the phone to a client query:
- “My fee is $200 cash pay and I don’t take insurance, but give me your insurance card and I can just check and run your benefits through the system to tell you immediately whether you have these out-of-network benefits, and how much you could get reimbursed per session, and we can help you file the claim!”
Having this conversation can help clients who might be on the fence about taking sessions with you when you aren’t fully on their insurance. Not everyone can pay their full fee, so these systems can help clients get to the therapists that they want to see without paying out of their budget or the therapist having to lose money to see the client.
Christine’s advice to private practitioners
Being in private practice is admirable! The fact that your business serves the community and you weren’t taught about business in school is brilliant, but feel safe to reach out for help. Organizations like Mentaya are here for you!
Sponsors Mentioned in this episode:
- Register for Level Up Week now to attend one of more of these amazing free webinars and take the next step in your private practice journey.
- Trust me, don’t waste any more of your time, and try TherapyNotes.
Useful links mentioned in this episode:
Check out these additional resources:
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- Apply to work with us — a decision-making matrix for your next steps
Meet Joe Sanok
Joe Sanok helps counselors to create thriving practices that are the envy of other counselors. He has helped counselors to grow their businesses by 50-500% and is proud of all the private practice owners who are growing their income, influence, and impact on the world. Click here to explore consulting with Joe.
Thanks For Listening!
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