Joe Sanok 00:00:00  You're someone with a vision for your practice, for your side hustle, and for your personal journey. But when it comes to establishing your path and how to get to where you want to be with your practice, things get a little messy. You're also someone who'd prefer to go in person instead of to groups and listening to everyone else's story. To me, it sounds like you could benefit from one on one consulting with our experienced practice of the practice consultants from 595 a month and up. You can work with a consultant that will give you more direction and practical, tried and tested tips matched to you and your goals. For more information, visit practice of the practice. Com forward slash apply. Again, that's practice of the practice. Com forward slash apply. This is the practice of the practice podcast with Joe Sarna session number 130. Welcome to the practice of the Practice podcast. I'm Joe Stanek, your host, and I am so excited that you are hanging out with me today. Today we are giving you behind the scenes in regards to our membership communities.

Joe Sanok 00:01:16  And so a lot of our consultants are doing teachings every single week. every Tuesday, Wednesday and Thursday we have live teachings going on in our membership. So we wanted to give you a little behind the scenes. So we're going to be hearing from Nicole Ball talking about what to do when referrals are slow, our basics with Andrew, client retention with Ashley, scaling with Nicole Ball, choosing the right project management systems, and all sorts of other things over the coming weeks. I can't wait to dig into this with you. If you want help from one of our consultants, please head on over to practice of the practice. Com forward slash apply. I'll chat with you for 30 minutes to determine if one of our membership communities or consulting might be right for you. Now let's get started with this episode.

Nicole Ball 00:02:01  Hello, everyone. Welcome. All right. I see some new faces. I see some faces I've seen lots of times. Thank you all for being here. I am really, really excited to be doing this new series with you.

Nicole Ball 00:02:15  So if you've been with me before, you know a little bit about me, but since we have some new folks with us today, I'm just going to give everybody a little bit of background of who I am and what I do here at practice, the practice. So my name is Nicole Ball. I am a practice owner in Northern Michigan. I have relocations getting ready to open up my fourth location. very, very excited when Joe said, hey, you want to join practice with the practice? Because I've known Joe for years and years, even before, all of his work with, you know, practice of the practice. So was really excited to come on and share some of my experience. and if you've been with me before, you know that a lot of what I share is just based on my experience in my success. I have $1 million practice and it's pretty exciting to see, see the growth. But as you all know, being in this position, it doesn't come without a lot of hard work and you have to find out what works for you.

Nicole Ball 00:03:13  So something probably going to hear me say a lot of is, this worked for me or this is my experience, simply because that's what I have to work on. that's what I have to work with. So, I've been in private practice since 2016. I also teach full time for Ferris State University. And for those of you who know Michigan, it's like, right about there. I'm up here, so I've got a little bit of a drive, and then I have another practice here, and I'm going to open another practice here. So I'm kind of in this little, pinky corner of, of Michigan, but, teaching full time for Ferris State. If you've been with me before, you know that I talk a lot about my experience there. because I love utilizing interns, which we'll talk about in a couple of weeks. So. All right. So today and this this kind of series for August is really preparing you for the busy season. If you've been in practice long enough, you'll know that when school starts, things get busy.

Nicole Ball 00:04:13  And I think that that happens for a couple of different reasons. Number one, for those of you who see kiddos or teens or families, what we find is that oftentimes when people are getting back into their regular routine, whatever that looks like, whether that is school or, you know, sports, extracurricular, extracurricular activities, parents are going back to work, maybe after having the summer off. What we find often is that, when people get back into that regular routine and schedule, a lot of the lackadaisical, fun of summer disappears and all the things that people have been brushing under the rug will kind of emerge, once the routine comes back. So, we do usually find that when school starts, when people get out of the summer. You know, the summer fun, they get back to real life. And real life includes addressing mental health, family dysfunction, addiction. you know, I usually get a lot of clients who want to quit smoking or want to lose weight that time of year.

Nicole Ball 00:05:16  So I get a lot of folks who are looking for help with that transition. we get a lot of referrals from schools that first few weeks as kids are transitioning, transitioning and struggling with the transition, whether it's into high school, into college, maybe a new school, parenting time changes. So if we're working with co-parents, oftentimes of kiddos have been with one parent for the summer, or had a lot of, you know, extended time with one parent after summertime, they oftentimes go back to that regular schedule. And then I don't know about you, but, I also believe the increase comes from folks just being ready for a change. I like to do my goal setting. Actually, I'm camping this week and kind of tell I have a little bit of a different background today. but I'm camping this week and I always camp the second week of August for one full week. And every year I sit by the river and I plan out my goals for the year because I like to set my goals this time of year rather than the new year.

Nicole Ball 00:06:13  Because in the new year, you know, we're getting ready for, we're in the middle of winter. For those of you who are up north. we're in the middle of a holiday. We're in the middle of a holiday stretch. I don't think January 1st is a good time to set goals. So for me, my goals always start Labor Day. So I like to spend the second week of August kind of preparing for my goals. What I'd like to see for myself personally, professionally, within my marriage, for my kids, for my health. and I think a lot of other people are doing that too. So I really think that's why we see an increase in clients and phone calls and website inquiries this time of year. I always reach out to my clinicians this time of year and just remind them, hey, we're going to start getting busy. So this series is about preparing for that from a success standpoint. I have a little bit of an outline I'm going to share with you today in the comments.

Nicole Ball 00:07:06  But before I start sharing the actual outline, I do just want to, I guess, give you a starting point. And for me, the starting point is the importance of preparing for the busy season. I think if we come into this season just expecting the same things that have always worked to work, there's a good chance you'll be successful. but I think if we don't prepare for the increase in clientele, if we don't prepare for the opportunities for increase in clientele, we're going to miss some opportunities or have big messes to clean up later. So really what we're looking for is the implementation of of operations and systems that are going to help us be ready for when the phone started ringing. Help us be ready for when we start, you know, getting that increase in, in clients that are reaching out to us or increase of referrals. I don't have a PowerPoint today for those of you who enjoyed my PowerPoints, but I do have a really nice outline that I will put in the comments once we're done chatting today.

Nicole Ball 00:08:09  And if you've never been with me before, you know that I like to include a lot of participation. So don't be afraid of my Socratic questioning when I say tell me about that. Or what's that like for you? because I think we can gain a lot of information from each other as well. Also, this will be in the practice of the practice recordings. So if you have to leave early or anything like that, you will still have access to the recording. So thanks for being here today. All right. So system number one appointment scheduling and management. That's number one. Now most of us already have an EHR that we use. We have some kind of online scheduling tool. We have something that keeps our practice organized, to manage all the things for our practice, whether you have simple practice therapy notes, therapist, whatever it is that you use, you already have that in place. But this is a really, really good time of year to go into your settings and make sure that you have all the settings in place.

Nicole Ball 00:09:05  And this is obviously in anticipation of volume increasing, but it's also to avoid the challenges that can come from that volume increasing. So the first thing that I want you to consider is with your online scheduling tool, number one, reminding all of your therapists to have their availability open. So just like us, our schedule changes after the summer. So do all of our therapists that work for us. So in my little hey everybody, get ready for the busy season email, I also include, a section specifically about making sure that their availability is updated, the availability that they've kind of had all summer, or maybe they've had an ongoing opening every Wednesday at two. Maybe that's not going to be available anymore. Also, when you let your therapist know that, hey, we're going to be expecting an increase soon. if you want more clients, now's your chance to snag them. this will encourage them to make more availability within their online calendar and their availability settings. So when it comes to system management, when it comes to scheduling, the easiest thing you can do is simply remind your therapist to have their availability open.

Nicole Ball 00:10:18  Be open to looking at, additional availability and then also be open to different availability. So I think you probably know where I'm going with this. With the increased in volume that comes this time of year, it's usually people who are working full time, kids who are going to school and people who are going to need evening and weekend appointments. So if you have a therapist who's like, oh gosh, I just I really want to increase my caseload. And and I'm just, I don't know, like, I'm not getting the cases I want have that conversation about being open to nights and weekends. I have very strict boundaries. And if you've been with me before, you know that I talk a lot about setting boundaries. But two times a month. So two Tuesdays, every every other Tuesday I work until 7 or 8 p.m.. Now, I put my years into my time and so I can do that now. But for some of maybe your younger therapist, if they're looking at building their practice and building their caseload, encouraging them to look at the additional availability in the effort to build their caseload, but also to have a space for those clients to go.

Nicole Ball 00:11:28  I have a rule at my practice where we never turn clients away unless we explicitly do not accept their insurance. I never want to turn anybody away, so I would hate to have somebody call and say, hey, I need something after school hours. And I would hate to just be like, oh, sorry, we don't have any therapists who offer after school hours or weekend hours That is lost money out of my pocket. And so I'm encouraging your therapist to be open to that as good. And then if you don't have therapists that offer that, start seeking out that specifically find yourself a therapist that can specifically do after school hours, possibly some weekends, even if they're very part time. I just brought somebody on who only wants to work Saturdays and Sundays. Why not? You know, I why not take on somebody who only wants to work Saturdays or Sunday? I'll get them full really quick. So as a practice owner, be open to that. So going back to my original point here, when you reach out to your clinicians, reminding them of the opportunities that are before them with keeping their schedule open, reviewing their availability, being open to additional availability, and then have them, you know, speak with your intake coordinator.

Nicole Ball 00:12:45  So if you have a scheduler or an intake coordinator. And they're ready for something new. Encourage them to talk to that person. And I'm going to give you an example of that. I had a therapist who was a little bit newer under my supervision. And, you know, in the beginning, you know, how you give those new therapists the easy cases. And she's at a point now where she's ready to take on some tougher cases. And if if she does not inform our scheduler or intake coordinator about that, the intake coordinator is going to keep giving her the easy cases or bypass her when a hard case comes in. So again, not only looking at their calendar and opening that up and being open to taking new clients, but also making sure that your intake coordinator for your scheduler is open or is aware of those changes. So maybe somebody who's never worked with children and they're ready to give it a try. Maybe somebody has always, you know, stayed away from couples and now they they're willing to take 1 or 2 couples, couples, clients.

Nicole Ball 00:13:45  Maybe a client had a really tough trauma case this summer and they were like, wow, I did really, really well. I think I could take another one of those. It's important for them to reach out to your scheduler or your intake coordinator, and let them know that they're willing to take on new kinds of cases. So that that, I think is a huge part of preparing for success is preparing the calendar, preparing the availability, and then also just making sure that you have a system in place for your waitlists, for your cancellations, for your automated reminders and confirmations. take a look at those. Something that I do every year is I just I use simple practice. I hop on simple practice, I go to my automated reminders, whether that is new appointment, you know, new intake reminders, whether that is the 24 hour appointment reminder, whether that is a past due bill reminder. Minder and I just go through those and I edit them where necessary, because maybe the language that I was using a year ago just doesn't fit anymore.

Nicole Ball 00:14:52  Or maybe I could put something that sounds a little bit better. So just make sure that you have those automated reminders, those confirmations, the cancellation management features, make sure all of those are in tip top shape, make sure the language is how you'd like it to be, and make sure that, basically your current scheduling practices and tools are working for you the same way now as they did before. And then if not, be open to making those changes. So that's system one out of my four systems to implement before the busy season is just reevaluating your appointment, scheduling your appointment management. And I know this seems like something really simple, but this is something that I'm almost positive brings me more money in. And remember, that's why we're all here, right? We're here to meet business owners and to make more money. So, And don't be afraid of saying that. You've heard me talk about that before. just be be willing and open to review those things. Just because they've always worked doesn't mean that there's not room for improvement, and doesn't mean that there's not room to just take a second glance.

Nicole Ball 00:15:55  And then it also doesn't mean there's not room to remind your clinicians on your team of where they could make new open availability, maybe where they can broaden their own practices and start working with different clients. And then also don't be afraid to find somebody part time who just wants to do nights and weekends, because I would say I probably have six out of my 32 therapists that only do nights and weekends. They have other full time jobs, but they do two nights a week and every other Saturday for me, and it gets a little bit of extra money in their pocket and it keeps my practice moving, so I never want to turn anybody away. So that's system number one. You know that I like participation. So any comments or questions about re-evaluation of your practice management systems and appointment settings. All right. Well moving on to system number two. So the next thing that I'm going to be talking about is your kind of the same thing. But your client records and documentation management. Your practice is going to likely get more busy.

Nicole Ball 00:16:57  And it's important that with that busyness, not only are we making sure that we have efficient record keeping, but that we are continually in compliance with confidentiality and accessibility, and professional practice. So I know this seems kind of simple like, well, Nicole, we've already done that when we set up our practice, just like our practice management for scheduling, it's important to reevaluate these and make sure that they are in place. another reason that I like to talk about specifically recordkeeping is because I have a lot of clinicians who take really, really long to write their notes. And I don't mean long as in like, they're way behind, like getting their notes done 2 or 3 weeks later. it's taking them an extra half an hour, 20 minutes to half an hour for each client. my goal is four minutes per session, four minutes per progress note for four sessions. And that's how I train the clinicians as well. is it should not be. Once you get it down, it should not be taking you any more than four minutes to write your note.

Nicole Ball 00:18:04  So what's going to happen is if your volume increases for clients, something that will also increase is the time it takes to write progress notes. And if you have a clinician who's taking 20 minutes, let's just say a half an hour to write progress notes, and they get five new clients this fall because their practice increases. that's an extra almost three hours per week that they're going to be spending doing progress notes. So when I talk about effective recordkeeping, I'm not just talking about the use of your EHR. I'm talking about the time that it takes you and for your team to write efficient notes. Now, I'm not saying that you should be writing crappy notes because we don't want to do that. What I'm saying is re-evaluate your templates in your EHR system. Most likely, you will have an opportunity to create your own template for progress notes. So I love simple practice. I pay a little extra for it, and I know a lot of people left when they increase their rates. But you've heard me talk about before.

Nicole Ball 00:19:05  I love simple practice. other great ones out there, but I personally love it. And the note templates they have, they're great, but they're Soap notes. They're DAP notes. They're, you know, the notes that we learned in, in grad school that are a little bit obsolete now, especially if you're accepting insurance. You're accepting insurance. You know, the insurance companies want a lot more in your note than that. So the great thing about the EHR system is I was able to create my own note template that allowed me to have everything that I wanted in my note specific to the insurance companies that we see. So I was able to create checkboxes and I was able to create dropdowns. I was able to put a quick and easy, mental health status exam in each note with a dropdown. I was able to put a little section that validated the reason for a session over 53 minutes, because if you work with insurance, you know that they want us to be able to tell them why we needed 53 minutes.

Nicole Ball 00:20:10  So point being here before I get on my little soapbox about insurance companies, requests. this is this time of year is a great opportunity for you to review your your own personal note practices, the templates that you have in your EHR system, and how you can change those to be more effective and more efficient, and then how you can train your, contractors, the folks who are under your supervision or your w-2s. how to take more effective notes. So how can they not be spending a half hour per note after each session? Because that's time they're not getting paid for most of the time. so why work when you're not getting paid for it? Well, if you can get more efficient with your notes and your note taking, you're going to find that you are spending more time with your clients, more time with your family, more time making money than you are just taking notes. So effective recordkeeping when your practice is busy is very important. Now, this doesn't mean that we have to sacrifice compliance confidentiality.

Nicole Ball 00:21:22  It doesn't mean that we have to sacrifice, a professional writing, all of that. can still be in the note, but if you have the opportunity to make that note template what you'd like it to be, I would encourage you to do that.

Speaker 3 00:21:35  I have a question, Nicole.

Nicole Ball 00:21:37  Absolutely.

Speaker 3 00:21:39  is it possible for you to even just do, screen share and show us this? Because I have therapy notes and it's not as customizable as simple practice. And I feel so jealous that you guys can do more customizing, but I'm not ready to abandon therapy notes. It's just like a peek at it. Can you show us? Let me see.

Nicole Ball 00:21:59  If I can do that. let me see if I think I have, like, a fake client I could pull up. Yeah, I would love to do that because I have had people ask, what does your note template look like? And I can't share a blank note template, but I could share with you, if I have a fake client, what that looks like, and I have based the note template that I created specifically on what insurance companies have looked for when we've had audits before.

Nicole Ball 00:22:22  And I know everybody's scared of audits, but y'all don't be scared of audits. The way I feel about audits is, you know, it's a learning opportunity. And if they say, hey, you're not doing something the way we'd like to see it, then I can implement that. and then we're good to go. let me see. I got a fake client here I can pull up and share. Yeah, thanks for asking. I think that works well. Yep. July 23rd. Okay, let me screen share here. so this is a fake client called July 23rd, and on July 23rd. So, that's another thing I do, y'all, if you're interested, is I always, while I'm training my new clinicians, in simple practice right there, when I'm with them, I create a fake client that they can play with so they can practice doing a progress so that I can look over. They can practice doing a treatment plan. I can look over and so and see Stephenson when I when I brought on Nancy, we created a client called July 23rd.

Nicole Ball 00:23:25  So if you go to this dropdown here, there's all kinds of different progress note templates. And these all of these are ones that simple practice just has in their archives a Adapt eMDR a family a simple one. The simple is just a blank page group. So and if you look here, you can create a new template, but I'm going to click on the one that I created. So the one I created is called the Mental Wellness Counseling Detailed Practice Note with mental Status exam. So if you click on that okay. So this is the template that I created. Insurance companies often want to know who was present at the session both you and the client. The location of the client. So if it was a virtual session where physically was the client or if you have multiple offices, which office was the client at the exact start and stop time of the session? The overall content that was discussed in here, I encourage, you know, I guess I don't need to train you all on notetaking, but, this is where I just have them give a brief, very vague, information about the content.

Nicole Ball 00:24:27  And again, I'm talking for a minute notes. I'm not talking big a book. insurance companies oftentimes want to know why we couldn't do our job in 53 minutes. So I have created this little box that you have, why you needed extra time. And these are all the things that I created. You know why? Why would we need to do a session over 53 minutes? Well, maybe the client was in crisis. Maybe there was new trauma. Maybe the client doesn't have a good support network. The one that I'm often clicking is. Symptoms are impacting multiple domains providing psychoeducation or intensive therapy. So if you're doing eMDR brain spotting, you know anything like that. This is a good one to check as well. Next up is Mental status exam. And I just made this a quick and easy dropdown so I can just quickly say the client was oriented. They were appropriate. their mood was good and so on. And insurance companies like to know the medications that they're on or any changes in medications.

Nicole Ball 00:25:23  So that's where I have this information. And then the in my opinion, and you may feel differently, but in my opinion, the most important part of your accepting insurance is current functioning symptoms and impairments. This is where we talk about the symptoms the client is experiencing, what the impairments are because insurance companies would like to know the, reason, the what is the medical necessity for this client seeking services. So this is where you would put, you know, if there's any issues with functioning, what their symptoms are impairments, you know, on a 1 to 10 scale for anxiety. Where are they this week? what was that panic attack like that they had last week? How is their anxiety impacting their relationships? How is it impacting their sleep and so on. The next little checkbox is any interventions that we use eMDR, CBT, person centered motivational interviewing, narrative therapy. and then the really great thing is if I get a new therapist and she's like, hey, Nicole, something all the time is not on here.

Nicole Ball 00:26:24  It takes me two seconds to hop on the template and add another box. I would say probably these last, like, I don't know, ten Are all ones that my clinicians were like, Hey Nicole, I use this one thing. Can you add it? And it's a quick, easy add. Then finally progress towards goals, barriers and plan. Sign and save. And that's it. So that's really something that I love about simple practice. And likely, you know, your own EHR system is you can very, very easily create your own templates. The other thing I love about that, that I didn't show you is after you type everything in, you hit a little button that says load. Or when you have a new session, you hit a button that says load last note and your note from the last session pops up, and then you just make the appropriate changes. So these are things that not only you can be doing, but you can be training your your clinicians to use. So we want to make sure that we're effective with that before we get too busy.

Nicole Ball 00:27:19  Was that helpful?

Speaker 3 00:27:19  Michelle very much. Thanks for sharing. Nicole. I have a follow up. Sure. so you have your interventions all like checkbox, which I love because we tend to use the same interventions over and over. has that note format gone through like an insurance audit? Are they okay with just like those little snippets of what we're doing?

Nicole Ball 00:27:42  I mean, I have never heard back anything negative about them. I did have another practice owner say, oh, Nicole, you're going to get docked for that because they want to see in your narrative that you use I use cognitive or, you know, the clinician use cognitive behavioral therapy to help the client connect their thoughts, feelings, and behaviors related to their anxiety and their upbringing. You know, I've heard that before. but we haven't heard anything negative. When I am training people, I do encourage them to write something in that top section, that content discussed with a little bit about the interventions, just to be safe. But no, I like the checkboxes because honestly, I'm probably always using CBT, motivational interviewing, solution focused interviewing, content and emotion evaluation.

Nicole Ball 00:28:26  I'm using those every session plus everything else I'm using. So I've also been using a lot of, a act as well lately too. So I don't know if that's helpful, but that's definitely something that, you know, to be aware of.

Joe Sanok 00:28:48  It's never too early to start thinking about tax season. That's why I've partnered with my friends over it. Heard. Heard serves as the financial back office built specifically for therapists in private practice. They're an all in one financial solution that combines software with human support to handle bookkeeping, taxes, payroll, and more. Regardless of whether you're a seasoned clinician or in your first year of your practice, heard will identify growth areas and streamline best financial practices for your business. When you sign up with heard, you'll connect your bank accounts so your transactions will be automatically pulled in and categorized. My favorite thing about heard is their allocation guide, which helps you decide how much to pay yourself each month and how much to set aside for taxes. You'll also receive financial insights such as profit and loss statements and monthly reports.

Joe Sanok 00:29:45  You can say goodbye to poring over spreadsheets and guessing your tax deductions or quarterly payments. Focus on your clients and heard will take care of the rest. Sign up for a free consultation today and join heard. Com forward slash Joe and get one month free with promo code Joe. Again that's join heard.com/joe.

Nicole Ball 00:30:10  Thanks for asking that Michel I appreciate it. okay. What's next with client records? just reviewing your record keeping methods review if there's any gaps going on. Review. and I know I talked about this in the previous webinar, but review if your staff is actually doing what they're supposed to be doing. I have a rule in my practice where notes need to be signed and locked within seven days of the session, and I continually have somebody who's behind. Maybe it's time for a conversation before the busy season because, you know, maybe this summer I've been letting it go a little bit. Oh, they'll catch up, they'll catch up. They have this going on and that going on. But at the end of the day, if they are too far behind and they start getting really busy, they're going to get really behind.

Nicole Ball 00:30:54  Really. So we want to make sure that those are in place as well. and then just, you know, evaluating whether you like your EHR. That's another thing. This is a good time of year to evaluate. Maybe it's time to move on to a different one. you know, do you have good storage? is there is there streamline in your documentation and just being able to train your people on that? Does it fit your practice needs that your practice grows basically. So that is system number two client records and documentation management. Any questions about that before I move on to number three. All right. Number three. You all have heard about a million, gazillion times, both in grad school and since you've been out of grad school. But I'm going to talk about it because it's important. System number three is making sure that you are implementing your own self-care work life balance, okay, because it is going to get busy for most of you, especially if you've been following some of the marketing things that we've been talking about all summer.

Nicole Ball 00:31:50  it's going to get busy. So not only encouraging you as a practice owner to take a look at your own self-care and work life balance strategies. But a nice little snippet, something that you can share with your therapist on your team to remind them that during these high demand periods, we want to do everything we can to not only be effective, but to maintain, the strategies to keep us from getting burnt out. Right? We want to prevent burnout. So balancing your workload and your personal life, setting boundaries, maintaining the effectiveness, Reevaluating what may have worked for you in the past won't work for you anymore. So a good example of this is for me. I would always do 7 a.m. sessions two days a week. because I, you know, I have to travel really far from where I teach. I was already up early. Anyway, my kids were taken care of during that time, so I would do 7 a.m. sessions. And I decided that this year for my own work life balance, that's not going to work for me anymore.

Nicole Ball 00:32:53  So those clients that I see at 7 a.m., I had to have a talk with them. We had to find something else that was going to work. for one of them, it just wasn't going to work. They needed the 7 a.m. session, and I couldn't provide that. And as terrible as it was, you know, I had to move them on to another therapist at the practice that would be more effective with them and provide that to them, because I had to set my own boundaries for my own work life balance. So some things to think about are your scheduling and your own time management. Where do you block things out? how are you taking care of yourself? What apps are you using that are helpful? Maybe you've never used your EHR app on your phone. Give it a try. Makes life a lot easier. maybe you have always had your email notifications on your phone. Maybe it's time to take them off after 6 p.m.. So start thinking about those kind of things. This is a good time of year to reevaluate your own boundaries and reevaluate your own, management for yourself, and then encourage your therapist to do it, too.

Nicole Ball 00:33:50  think about what resources you've never used. So a good thing. For me, I'm always recommending these podcasts and these apps to my clients, and some of them I've never used. So, you know, when I was working on when I was sitting by the river last night working on my my goals, I was thinking to myself, okay, like, I'm going to start using this app that I keep telling my clients to use. I know what it is. I've seen it before, but I've never actually used it for myself. So how can you utilize the resources and the tools that you give your clients, or you give your therapist or, whatever, You know, start using those things. even though we are practice owners. and we may not be getting regular supervision anymore. Maybe it's something you need. This is another thing that is helpful for work life balance. maybe you had a mentor a long time ago that it's time to reach back out to. Maybe you had a supervisor before that.

Nicole Ball 00:34:43  Maybe you'd like to do quarterly check ins because you're noticing that you could use that. maybe you just need more of a team approach. So how could you implement that into your practice? and then really, I think the big takeaway here is and again, you all know this is developing a self care plan and identifying your own personal needs. Because if you're always looking at the practice needs, you're going to get the crumbs left over at the end of the day. And if you're getting the crumbs left over at the end of the day, your family is getting the crumbs to maybe the family is getting a little bigger chunks, but they're still getting the crumbs too. So making sure that you're balancing out, not just your practice, but your personal life as well. So what tools can you use for time management and for yourself? So that's system number three. I threw that one in there last minute, but I just I couldn't leave it out because again, I'm I'm preparing myself for the busy season August 26th.

Nicole Ball 00:35:37  That's I think 26 to the 28th, whatever that Monday is. My life is going to change dramatically on that day and I know that the phone's going to start ringing. I know that things are going to get busy. so keep that in mind. All right. Finally, we have system number four, marketing and referral management. This is a beautiful and perfect time of year to reconnect with your referral sources. just a friendly. Hi. We're still here. We're still accepting new clients is usually sufficient. So at this time of year, I always do a formal letter and or a formal email to my, to all of my regular referral sources just to say, hey, you know, happy New year. Happy new school year. I usually offer some level of, you know, just greetings and hello. But the big thing is, I remind them that we're still taking new clients. I remind them that we are still open. maybe if we have some new clinicians that are good fits for their clientele, I will tell them about that.

Nicole Ball 00:36:42  Maybe if we have new programs, new sliding scales, new events coming up, or if there's just new news in general, like, hey, we opened up another location. That kind of a thing. I like to just say hi there. Hello. We're still available. We're still ready for your referrals. Just as a reminder, this is the best way for you to contact us. This is the best way for your clients to contact us. And just really offering that reminder that we're still here. This is going to ensure that steady stream of clients from that referral source. So something that I do the very first week of school is I send an email out to all the school social workers. And if school and school social workers change a lot, we know that. so I will call the front desk the first week of school. I will say, hey, who's your school social worker this year? Who do I need to talk to? And I get their email address and their phone number and I shoot them an email.

Nicole Ball 00:37:36  Hey, my name is Nicole. I own mental wellness counseling. We have this many therapists, you know, if you have any kiddos, if you need any referrals, if you need any support, let us know. Happy New Year. That kind of a thing. and that gets us clients. I will reach out to all the pediatricians offices, because it's usually this time of year that kiddos are seeing their pediatrician or going in for their sports physicals and things like that. So I'll reach out to the pediatrician offices. sometimes I'll reach out to other practices that we have collaborations with. I reach out to the hospital in their, behavioral health. I reach out to a lot of people, and I do that in a specific effort to just say, hey, we're still here. Holler if you need us. Not only does that ensure a steady stream of new clients, but it also strengthens that professional relationship and trust. Right. If you've been getting clients from them, it it builds trust and it strengthens that relationship to say, hey, we're still here.

Nicole Ball 00:38:30  We're still accepting clients. These are the changes. Let us know if you have questions if you need anything. I'm not doing it this year. But last year I was doing a little side gig where I would offer professional, self-care professional development seminars to businesses. And so I would just put a little blip in there that says, you know, hey, if during any staff meetings you're interested in having me come in for an hour, I would love to come talk about what we do, at my practice or provide something related to conflict resolution, stress versus burnout and how to prevent burnout. You know, some of those things that big corporations or, you know, big companies are interested in hearing, that's something they like to hear. Now, if you're looking for new referral management to reach out to. Something that I recently found helpful was to reach out to the large companies in my area that I know, accept my insurance, and reach out to their HR people. So, you know, if you find that the biggest employer in your town accepts the insurance that you, or offers the insurance that you accept reaching out to their HR person, just saying, hey, you know, I noticed that your company, offers their employees Blue Cross Blue Shield.

Nicole Ball 00:39:43  I just wanted to let you know that my practice accepts Blue Cross Blue Shield. We currently have openings for A, B, C, D, and F, and, that can be pretty helpful too, because oftentimes if somebody's struggling at work, they're going to go to HR or they're going to get sent to HR or somebody's going to, you know, give, give HR or poke, and then HR department will say, hey, I know this practice off the top of my head, here they are. So that's another option for the new year or two is just starting to develop those new relationships. When you update these referral sources, it's also important that you update them on any new availability. So if you have therapist who traditionally have not offered nights and weekends and now you have them, that's always helpful to remind them of that. Remind them of how to get Ahold of you. and then this is also a good time to update your digital marketing. So if you have social media, this is a good time of year to update your social media and clean it up.

Nicole Ball 00:40:39  Take a look at your social media and find out how many likes you've gotten. And if you haven't, identify how you can get more. Invite more people to like your page. Tell your friends and your family and your colleagues to like your page and encourage other people to like your pages. this is always a good time of year to take a look at your digital marketing and your you know, where you are on the web so that you can ensure that you're getting the most referrals from that as well. and you don't need a marketing manager to do that. That's something that you can do on your own too. Don't get me wrong, if you have a marketing manager, good for you. For me, I just like to do some of that on my own because I like to have my hands in it. but it's a good time of year just to peek at it and see where you're at and see, are you getting people from that, you know, let's say social media to your website, because remember, it's all about website clicks.

Nicole Ball 00:41:28  The more clicks on your website, the higher you're going to rank on Google. So how are you getting those backlinks? How are people getting to your website from another website? How are people getting to your website from your social media? So it's a good time of year to go through, clean up your website, clean up your digital, marketing, clean up your social media, and just really come up with a good, effective plan. and then I don't do it. I really want to, but another practice on a friend of mine, what she does is this time of year, she takes August and she, she preps all her social media posts for the whole year in August because you can, like, put a date that you want things to post. So her social media is just automatic and she just spends a little bit of time doing it and that's all done. So, so yeah, that that's my little reminders for the upcoming busy season. Now, I'm not telling you, any of you, anything that you don't already know.

Nicole Ball 00:42:23  These are all things that we've talked about in previous webinars. They're all things that we've talked about in, you know, maybe personal, consults that you've had with me or with other people at practice in the practice. but I think it's an important reminder for this time of year because like I said, come September, most of the time around Labor Day or after Labor Day, you will see an increase, but you will see more of an increase. If you do follow some of these steps, and then you will have less messes to clean up if you also follow some of these steps. So these are some things that I want you to consider. I am putting this outline that I just talked about, in the chat. So if you'd like to copy and paste that, you're welcome to it does. It did not come out as an outline. It's all kind of squished together because it's a chat box, but it's there if you'd like it, so I'm putting that in there right now. so that is there if you would like it.

Nicole Ball 00:43:25  We did have somebody ask if they have an employee handbook anybody would be willing to share. that's something that we can consider too. I don't have an employee handbook because all 33 of my clinicians are 1099. But I know that is state specific. Different states don't allow you to do that. and I know there's some scare tactics going around in some states, which is making people feel forced to move from 1099 W-2s. So I don't particularly have one, but if anybody has one, we can talk about that to I will be here next week. So next Tuesday, if anybody does have something they'd like to share, we can put that in the chat. or, you know, if you share it with me, I can, if you want to email it to me, I can certainly share it with the group as well. So that's that's an option too. So as always, I'd like I like to leave the last ten 15 minutes for comments or questions. and most of you know me, I'm an open book.

Nicole Ball 00:44:19  I'm happy to answer anything. I like the whole ask me anything strategy because I feel like we get the most from that. So what questions do you have? What comments do you have about some of the stuff we talked about, or concerns that you have about some of the stuff we talked about today?

Speaker 3 00:44:32  Well, I love your encouragement to your team to do a four minute progress. No, I love, love. That's what I'm striving for personally. And, that's what I want my people to do. But I haven't even been that specific in saying, like, let's shoot for four minutes. And I just feel like everything you said about it, I really resonate with. So I'm excited to, see what that can look like.

Nicole Ball 00:44:58  Well, and I think especially some new, you know, new people out of grad school, they hear four minutes and they're like, well, how can I because you're trained in grad school to be so objective and so specific. And so they're like four minutes, I'm going to write a shit.

Nicole Ball 00:45:12  It's going to be a mess, right? but it doesn't have to be. Especially when you hit the load. Last note feature. If you hit load last note, all you have to do is go change the content of what you talked about, how the symptoms, impairments, and level of functioning have changed for the client and then what their new plan is for the next session. Because if you think about it, that's what we're doing in session anyway. We're taking what we previously talked about. We're working it into new strategies and new plans. and then we're noting for insurance companies most of the time noting how their symptoms, impairments, have really changed. So it really should only take a few minutes. but we all know it's easy to get behind. So that's another thing is if you do have clinicians who are getting behind, you know, just that encouragement and that coaching and mentoring I think is good because even if you do have employees or. 1099, I don't think it matters. People are open to, coaching and mentoring in that area.

Nicole Ball 00:46:11  and then you know that you're going to get effective, notes, you know, that you're going to get quality notes. and at the end of the day, as practice owners, again, don't be afraid to say it. We're here to make money, right? I want to go on a many vacations. I want as a year and however many vacations I take. A year is dependent on how much money I make and how much money I make is dependent on the work that I'm producing as a practice owner, and the work that my clinicians are doing as part of my team. And so if that means, hey, we can be all more efficient and have more family time, more time with our dogs and our cats and our kids and our camping. Right. We want more time with that. That's going to happen when we have more effective note taking practices and practice management systems. Thank you Michelle, I appreciate that.

Speaker 4 00:46:59  In regards to notes, one thing we've started to implement our practice and my therapist loved it.

Speaker 4 00:47:04  We're starting to dabble into the AI technology world when it comes to note taking. And it's been a real game changer and lifesaver for some of my therapist. Like we're getting more timely notes. We're getting better quality note. Basically, we just the software is recording if clients are comfortable with that, and then we're just checking to make sure everything's appropriate and right. And then we can copy and paste into our EHR.

Nicole Ball 00:47:31  I love that. And I usually tell people if you're afraid of AI, just play with it. Play with it for ideas, because some of us get stuck on the language sometimes. And, you know, as a professor, I find that that's where my students get stuck to, especially my MSW students, where they're just like, you know, they feel like they're not being professional enough. And I'm like, well, first of all, you're not writing a, you know, it doesn't have to. It's not a research study. Like, it doesn't have to be super professional, but it does have to be professional enough to prove what we're doing is working and effective, or prove that our client has medical necessity.

Nicole Ball 00:48:04  And if you're having trouble with that language, you just go to ChatGPT.

Speaker 3 00:48:08  Type.

Nicole Ball 00:48:09  Something in to get an example. And sometimes just the example is helpful. So I encourage all of you if you're like, oh I, I don't know, just play with it and see how it feels. And if anything at least you'll get some ideas from it and you can see how that feels. Thanks, Brent. What else? Anybody else have questions or comments?

Speaker 5 00:48:28  Just a comment about the theme with with notes taking a long time. I feel like every year when I do my continuing education, I will try to do some of that. How to be more efficient with note writing. And I get in this like, like scared mindset about insurance companies and my notes just start expanding to longer and longer. I'm like must have more medical necessity to justify. And it's like, oh gosh, like it takes me forever. And so I appreciate like reminding that, you know, the reminder and also like lived examples that you can have more succinct information and it will still be just fine with any audits.

Nicole Ball 00:49:04  Yeah. Well and I think some something to remember is if we look in the DSM, right? Each diagnosis has what a page of the DSM like just a little page with like bullets of these are the objectives that have to be met to give this person this diagnosis. Why can't we do the same thing in our notes. Right. So if my client has, excessive worry and trouble controlling worry, trouble sleeping due to the worry, trouble with relationships as a result of the worry. And they are. And it's affecting their relationships and their ability to concentrate, work more effectively. Boom boom boom boom for things that not only qualify them for that diagnosis according to the DSM, why can't I put that in my notes and qualify it there as well? So that's kind of how I justify it as well, is I don't need to write a book. The insurance companies are not interested in my client's life story as to how and why they have these symptoms. The insurance companies just want our justification that like, yep, these are the symptoms the clients having because they said so.

Nicole Ball 00:50:08  So if you write the client reported 12345. Why can't that be a justification? I've never heard back from an audit that that was bad. So again, I'm just speaking from my own experience. But I've also have audits that I've never heard back from. I had an audit from Priority Health in February and I still haven't heard a thing back. I've heard nothing. I had to give over 64 clients files, entire files. So thousands of notes, thousands of I mean, just I mean, it was insane. I'm not trying to scare you because it was actually really easy just to go boop boop boop and upload it onto their system. it was just a little time consuming. But that happened in February, and I still have not heard back from Priority Health, so who knows, maybe I'll hear back in a year and they'll claw back $1 million. Maybe I'll never hear back from I don't know, but if I spend my time worrying about that, that's less time. That's that's negative energy that I'm going to let Future Nicole have.

Nicole Ball 00:51:03  Because Present Nicole just wants to focus on her clients and making money and being with her family. So. All right. It looks like we're losing people left and right. So thank you all for being here. I'm going to stick around if anybody has any questions. Have you got personal questions for me or if you want to chat really quickly I'm available. Otherwise I will see you all next week if you're joining me next week. Thank you for being here. Have an awesome day. We'll see you later. Bye.

Joe Sanok 00:51:34  Well, thank you so much for listening to the practice of the Practice podcast today. These trainings are available in our membership communities. Now we're going to be opening up our membership communities more than just when we're opening Level Up week. So if there's one that you are interested in, I would love for you to head on over to practice of the Practice Comm forward slash membership, where there's more details and you can get notifications when those open up. So if you are in solo practice, just getting going, if you are building and sustaining a sustainable solo, practice, next level practices for you.

Joe Sanok 00:52:05  If you are looking to launch a group practice, group practice launch is for you and group practice boss is for all those group practice bosses out there. You're thinking about the end of the year and taxes and wrapping all of that up. You need to connect with heard, connect with them before the end of the year so that you can get a free consultation to talk through your tax situation. There's tons of things that you need to think about year end and heard is going to help you with it. Head on over to join. heard.com/joe that's join h e ard.com/joe thank you for letting me enter your ears and into your brain. Have a great day. We'll talk to you soon. Special thanks to the band Silences Sexy for that intro music. And this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.