Alma: What You Need To Know (Complete Review)

Please Note: Despite the feedback from others, Alma as been an asset to my business and as such I have left my original review of Alma below if you wish to give it a try for yourself.

So often I see therapist asking in Facebook groups about the pros/cons of various therapy platforms such as Headway, BetterHelp, Talkspace and Alma. In a post-COVID world, I feel these questions have come up even more as telehealth grows and more and more individuals are starting and growing their own private practice. It can be overwhelming to decide which (if any) are good for you.

In this post I am going to take a deep dive into Alma and talk specifics as to how Alma helped me leave my agency job and start a fulltime private practice.

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Alma At A Glance

Alma Pros

Alma Cons

Why should you listen to me?

As a business owner and therapist, Alma became my one stop shop for billing, referrals, networking, and education. Alma was not my first decision when opening a practice, but it has been my best decision to date.

I started with Alma in October 2020 following a therapist friend’s recommendation. In full disclosure, she recommended Alma to me months before I joined but I was set on building a cash only business and wanted to try it on my own first. At that time, I was working full-time at a hospital based agency program, doing private practice as a side hustle with dreams of taking my business full-time for greater time flexibility and financial freedom.

Once I was paneled with Alma’s insurance providers (at the time it was only Oxford, Optum, UHC and Aetna), my practice was full in 2 weeks [This was in March 2021]. This allowed me to leave my agency job and work my private practice full-time; the dream I had been trying to achieve for nearly year before as an exclusive cash pay practice with no luck.

I chose Alma because I knew I needed to use insurance to build my caseload but had heard horror stories about the paneling process, billing and low reimbursement rates. Alma erased these concerns as they take care of all the paneling and billing, in addition to negotiation the highest reimbursement rates for insurance I have seen. By taking off the financial pressures, I was able to hand pick my ideal clients while still making more per session then I was at my hourly hospital job.

One of the perks of Alma is that they hire you as a 1099, meaning that your private practice and Alma are two separate entities. Because of this structure, once you leave Alma you are no longer obligated to use their insurances (unlike paneling yourself where you are locked in for 3-6 months). Alma also allows you the option to stop taking referrals when YOU determine that you are full, giving your 100% flexibility on the size and acuity of your caseload.

Update: My practice has been full since 2022 and I have not needed to market using Alma or Psychology Today to attract new clients. As of September 2023, I will be a fully out of network clinical practice and will not be accepting in network insurance contracts.

Insurance Billing Made Easy

Alma has announced to all members that it is a violation of contract to share rates publicly therefore I cannot disclose the exact rates of reimbursement but I will say on average I am receiving approximately $100/session which has been substantially higher then most independent insurance contracts I have researched. I can also say that the rates of reimbursements are significantly higher (2-5%) at Alma then they are Headway. Different locations and education levels have different reimbursement rates to my understanding (probably why they do not want the rates discussed) so it is important to reach out to Alma directly to get the rates that are specific to you. Rates may also change based on negotiations with insurance providers therefore the rates listed are only an example of what I am reimbursed and may not be representative of what your state/licensure/insurance contract will provide.

Because you are paneled with insurance under their tax ID number and working for Alma as an independent contractor, legally you can still bill your practice as OON (out of network) as it is a separate business entity. Because you are essentially working at two different facilities (Alma and your own practice) you can see both client under insurance (with Alma) and OON (under your own practice) at the same time.

Peer and Clinical Supervision

One of the unexpected perks of Alma is its robust community. When first signing up I originally dismissed this perk as I had built myself a large peer group. Once I became more involved with Alma I learned quickly that this was something special. Alma is constantly hosting webinars (live and recorded) on various topics such as EMDR, financial management for practice owners, documentation, special interest groups, and more. They additionally have an extensive library of resources both in text and video from some of the worlds top therapist and mental health influencers (Almas Clinical Advisors) such as Esther Perel, Guy Winch, Dr. James Wadley, and Lori Gottlieb.

Alma Pricing

Two pricing packages are offered, a month to month plan as well as a yearly plan. (Again these prices reflect my NJ rate as of 2022, I am assuming it is the same for all but I am not certain.)

Month to month plan $125/month

Yearly Plan $1,140 billed annually (that is $360 in annual savings)

When I started, I utilized the month to month plan for just under a year. I ultimately changed to the yearly membership due to the significant financial savings.

Bonus Perk: Alma also allows you the opportunity to pause your membership (both monthly and annual) for 3 months which was a huge help during my maternity leave.

Electronic Medical Record Included in Program

Taking accurate clinical documentation is essential for any provider. Alma makes this simple by incorporating dedicated space to log progress notes at the end of each session. This is a big bonus for the clinician who is just staring out and looking to keep fees low.

I’ll be honest though, despite the fact that Alma has its own built in EHR, I still prefer to keep my own records using an outside source such as Simple Practice.

Why?

For starters, last I checked Alma does not provide clinicians the opportunity to download their past records if/when a client should request them. This accessibility is important not only for client requests, but also case coordination with other professionals, as well as legal compliance.

As a NJ social worker, I am required to maintain client records for a minimum of 7 years. Meaning, if I ever left Alma, I would need to have a way to access those records easily. For me personally, I felt more comfortable using SimplePractice. Read my complete review of SimplePractice Electronic Medical Record, here.

Additionally, when I used Alma I did not have the opportunity to upload documents into the client file or write chart notes. Meaning if I wanted to keep a record of client phone calls, emails, no shows, treatment plans, case coordination’s, etc.. I was unable to do so.

If you are stuck on what to write or how to write your progress notes, the Practice Planners series are great resources for how to word your interventions. Below are the current publications that they have available:

• The Child Psychotherapy Progress Notes Planner
• The Adolescent Psychotherapy Progress Notes Planner
• The Adult Psychotherapy Progress Notes Planner
• The Severe and Persistent Mental Illness Progress Notes Planner

These publications are a great tool for getting ideas as to what interventions and goals to use with clients as well as gives examples of how to best word the interventions when crafting your treatment plan.

• The Family Therapy Treatment Planner
• The Complete Adult Psychotherapy Treatment Planner
• The Adolescent Psychotherapy Treatment Planner
• The Addiction Treatment Planner
• The Child Psychotherapy Treatment Planner
• The Couples Psychotherapy Treatment Planner
• The Parenting Skills Treatment Planner
• The Severe and Persistent Mental Illness Treatment Planner
• The Crisis Counseling and Traumatic Events Treatment Planner
• The Co-Occurring Disorders Treatment Planner
• The Family Therapy Treatment Planner
• The Group Therapy Treatment Planner
• The Social Work and Human Services Treatment Planner
• The Suicide and Homicide Risk Assessment and Prevention Treatment Planner
• The Veterans and Active Duty Military Psychotherapy Treatment Planner
• The Juvenile Justice and Residential Care Treatment Planner

Alma Competitors

Headway — free but much lower reimbursement rates, no referrals, and you get paid 2x monthly. It is good if you need a free option but does lack some key bonuses that Alma has such as a telehealth platform (Zoom) and clinical consultation community. For more details on Headway, read my complete review here.

Technically BetterHelp and TalkSpace are competitors however their platforms run so different that in my mind it is no competition

Who is Alma right for?

• Therapists & Counselors in mental health (i.e.. Phd, PsyD, LCSW, LPC, LMFT, LCADC)
• Psychologist, Psychiatrists and APN’s who conduct psychotherapy sessions
• Seasoned private practice owners
• Group practice owners
• New private practice owners with no specific niche
• “Generalists”
• Trauma providers —TONS of Trauma Referrals
• EMDR Providers
• Couples Counselors
• Practitioners looking for ample and affordable peer consultation and continuing education. At $95-$125/month its a great deal, where as many courses through programs such as PESI cost $200+

Who should avoid Alma?

• Unlicensed professionals and interns— One of the big draws to Alma is being able to bill insurance. If you are unlicensed or and intern, insurance will not cover your service therefore you must be cash pay only
• Alternative Healers such as reiki, cranio-sacral, massage, etc.— I have not seen much activity from or for these types of services through Alma therefore is your practice offers these services exclusively, I would recommend starting your own private practice
• Practitioner that has a super specialized niche and is getting private pay clients with ease. If your OON rate is higher than what insurance reimburses, and you are able to fill your practice with OON clients, then there is no need to use Alma for billing services. Alma is great option for peer consultation and continuing education however so if the $95-$125/month is cheaper then what you are already paying for those services it might be worth it.

Conclusion

If I could do it all over again, I would have done a shorter month to month “trial” of Alma to test out the system and be sure I was comfortable with it, then switched to the annual plan once I was sure I was sticking with it. Alma is constantly updating itself and for the better, although be warned that their biggest drawback as of late has been the extremely slow customer services response. If you are a serious practice owner (6+ clients weekly) looking to streamline your business so you can focus on clinical work, Alma is your best option.

HOWEVER….

If you’re just getting your practice off the ground and have a couple of clients, or if you are working full time at an agency and doing private practice on the side, Headway might be a better fit for you. The fact that it is completely free allows you to maximize your income, which is a huge benefit when you have a small case load of 2-3 clients weekly. Read my complete Headway review here.

Attention: Live Masterclass & Group Coaching April 18,2024

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