What Does It Take To Break Free From Insurance Panels?

Are you ready to ditch the insurance panels and become an out of network provider?

You may have already crawled through the internet looking for advice and asked all your successful therapist friends for help, but I hope to offer my ideas on what it takes to achieve a successful practice as an out of network therapy provider.

Many people believe that in order to have a full therapy practice you must find be paneled with insurance carriers, but that may be the exact thing that is holding you back from reaching your financial potential.

If you’re struggling with finding private pay clients, this is the place for you.

I’m Alexandria Theordor, a life first business coach who helps therapist build a private practice that prioritizes their personal life and values above all. I want to help therapist create the freedom to focus on what is most important: health, wealth, and relationships. This often times means helping therapist identify, map out, and create action towards a financial goal which prioritizes their personal and family values.

By providing consulting services and online resources to help therapists achieve success in their business endeavors.

My goal: to help you gain the confidence and knowledge necessary to launch your own profitable practice. Want to learn more about who I am? Check out my About Page.

But enough about me,

Let’s dive into a behind-the-scenes look at what goes into a fully cash pay practice.

Pre Work: Always remember to read your insurance panels contracts thoroughly before signing up and ultimately leaving

Before signing up with insurance panels, it is crucial to thoroughly read through the contracts provided. Take the time to decode the dense jargon and understand the terms and conditions laid out in black and white. Hidden clauses or restrictions buried within the fine print could potentially impact your practice in unexpected ways.

As a part of this contract review, be sure to carefully review the reimbursement rates offered by insurance panels for your services as a therapist. By understanding and being comfortable with these rates, you can ensure that they reflect the value you bring to your clients.

Different insurance companies may offer varying reimbursement rates, so it is important to compare and select panels that align with your expectations. This often is true if you hold multiple licenses in different states as rates can vary state to state (and degree to degree so don’t just assume that your doctorate level friend is getting paid the same as your masters level clinicians).

It is important to note that once you sign a contract with an insurance company, you are agreeing to their reimbursement rates and CANNOT bill the client for any price differential between that rate and your full fee price. This is called balance billing and is a direct contract violation that can lead to legal ramifications.

If you are not happy with the rate they offer, negotiating rates with insurance panels may be possible in some cases, allowing you to secure fair compensation for your work. Be sure to do any negations PRIOR to signing the contract.

Sometimes billing agencies like Headway and Alma, do the negotiations for you and can get you a higher rate then if you were paneling on your own. Something to consider when signing up.[For a complete review of Headway and Alma, click the hyperlinks above. ]

It is also important to consider the administrative processes involved in working with different insurance panels, as they can impact the efficiency of billing and payments. This is not a fee that you can charge to clients and should be included in your price calculations when setting your rate. For this reason, many therapists often elect to hire a biller or billing agency to conduct the submission of claims for them, however you can absolutely do this yourself with your electronic medical record such as SimplePractice. You can access a complete review of SImplePractice here.

Overall, being mindful of reimbursement rates and their alignment with your value proposition will help you maintain a sustainable therapy practice. By arming yourself with knowledge about the contractual obligations involved, you can make informed decisions that benefit both your practice and your clients’ access to care.

Ditch The Insurance Panels Tip 1: Customer Service Is Key!

When I first opened my practice doors I elected to not take insurance panels right off the bat. What happened…crickets.

Why?

Because I had NO REPUTATION as a therapist in private practice.

So my first and foremost tip for becoming an out of network provider: build a strong reputation amongst your ideal client population.

When considering the transition to a cash pay private practice, the importance of maintaining quality customer service cannot be overstated. Your current clients who have built a relationship with you are likely to follow you on this new journey, drawn by the trust and rapport already established. Note: This also includes the clients you worked with at your previous agency/community mental health jobs and internships— you never know where a referral might come from and when.

Additionally, happy clients who have experienced excellent customer service are not only more inclined to continue their own sessions but are also more likely to recommend your services to their friends and family.

By prioritizing quality customer service from the start, you not only retain loyal clients but also pave the way for organic growth through word-of-mouth referrals. This positive cycle can significantly boost your practice’s reputation and success in the long run. Making sure each interaction is personalized, empathetic, and fulfilling for both therapists and clients creates a strong foundation that will support your private practice as it evolves beyond insurance panels into a thriving self-pay model.

Ditch The Insurance Panels Tip 2: Have Clarity On Your Ideal Customer

Understanding your ideal customer is crucial when making the decision to step away from insurance panels as a therapist. By having clarity on who your target audience is, you can tailor your services and marketing efforts to attract clients who are willing to pay out of pocket for specialized care.

The saying the riches are in the niches holds true in this scenario, as clients are more inclined to invest in a specialist who can meet their unique needs rather than a generalist.

Speaking from both personal and professional experience, clients are more willing to pay out of pocket if there is a confidence that the professional is not only trained but PROVEN to get results. Especially in today’s culture where you can hire a “coach” for nearly anything and everything, knowing someone has a proven track record for succuss by deceasing a specialty can help up your chances of securing an OON client.

I myself have hired professionals (both therapists and coaches) and paid privately specifically because their specialty resonated with my goals. When I read their websites and social media, I felt as if they were speaking to me directly. This gave me the confidence that they knew exactly what I was going through and therefore had the proper insights to help. I personally will take a knowledgeable expert who has walked the walk themselves, over a book smart guru any day.

What if you are new to private practice and don’t have a track record, or client success stories?

This is where marketing your expertise is going to become essential. You are going to need to put yourself out there and SHOW people you know what you are talking about.

Showing, not just telling people you are an authority in the field is going to go a long way in helping build your private practice caseload.

Looking for help in this arena? My digital course: Grow Your Therapy Practice With Blogging goes over the ins and outs of how to use blogging as an authority builder in your marketing strategy.

Focusing on a specific niche allows you to showcase your expertise and stand out from the competition, positioning yourself as a sought-after professional in your field. Clients value specialized knowledge and skills, and they are often willing to pay higher fees for the personalized attention and quality care that comes with it.

Embracing this shift from serving everyone to serving a select group of ideal clients not only increases your earning potential but also enhances the overall client experience, leading to greater satisfaction and long-term success in your practice.

If you want to grow your private pay client base, you must enhance your marketing strategies. To kickstart this process, I am offering a complimentary 50-Question Workbook that will assist you in understanding your target audience better, enabling you to tailor your marketing content effectively. You can access and download the Ideal Client Workbook here to elevate your copywriting skills.

Click here to download 50 Question Ideal Client Workbook >>

Ditch The Insurance Panels Tip 3: Never Drop All Your Insurance Panels At Once.

When I decided to go out of network, it was a scary transition in my business because I had no idea if my current caseload would continue to work with me or not. I managed this uncertainty by slowly dropping my credentialed insurance provider contracts one-by-one in order to protect my income from drastic fluctuations.

By strategically reducing insurance offerings over time, you can gradually transition towards more lucrative opportunities while safeguarding against potential financial pitfalls.

When deciding which insurance panels to cut first there are some things you will need to consider:

• Of your current list of clients, which insurance is used the most? Depending on your financial goals and risk tolerance you may want to cut the least used insurance first to get your feet wet in the OON world. Or perhaps the opposite, if you are looking to make a fast transition and are willing to lose some clients early on then drop the highest used insurance panel.
• Look at contract dates and how much notice must be given. Some insurances require a specific number of days notice before terminating a contract. This is another reason why I liked using Alma & Headway (affiliate link)— because there was a greater flexibility in termination. (Obviously of course, no matter what the date, be sure to give your clients plenty of notice ahead of time as to not leave them abandoned. I like to give at least 6 weeks notice when possible, Ideally 12 weeks.)
• Which insurance panel has the lowest reimbursement rate. This is where I personally started especially since my case numbers were equally split between two primary insurances. By cutting the lower reimbursement panel, I was able to make room for new private pay clients while at the same time keeping the security of select insurance panels under my practice. Once I built my practice back up to a comfortable number, I looked at cutting the remining panel and slowly regrew again.

This incremental approach allows you to analyze the impact of each change and make informed decisions based on tangible evidence rather than assumptions. Remember, the goal is not just to survive but thrive in the ever-evolving landscape of healthcare reimbursement.

Ditch The Insurance Panels Tip 4: Ask For Referrals

When transitioning to a cash-based private practice, it’s crucial not to shy away from asking peers and colleagues for referrals. In the absence of insurance panels, word-of-mouth recommendations become your lifeline in attracting new clients. Building strong relationships with other professionals and encouraging them to spread the word about their positive experiences can significantly boost your client base.

When thinking about which providers to reach out to for referrals, consider which providers also work with your ideal client, just in a different capacity. Especially if they too have an out of network or cash pay business.

For example, I have done a lot of work with chronic illness clients who outside of receiving mental health services also visit chiropractors, cranio-sacral therapist, occupational therapist, sound healers, art therapists, and more. By reaching out to these providers and offering how your services can in fact help their clients (a win win) you may not only walk away with a referral or two, but some professional friends.

Ditch The Insurance Panels Tip 5: Ramp Up Your Online Presence

When you make the decision to stop accepting insurance, it becomes crucial to focus on marketing efforts to attract new clients. This may involve ramping up your digital presence through social media engagement, creating engaging content on your website, and having a rock star directory profile.

One effective strategy is to boost your online presence by actively engaging with social media platforms. This can help in reaching a wider audience and showcasing your services, building an image of authority and expertise.

Not into posting every day? Zach Spuckler teaches Facebook/Instagram ad content retargeting strategies in his membership which can help you build an omni-presence by repromotion your content to people who have visited your website and/or social media pages. To learn more about his membership, head over to his sales page here (affiliate link).

Another approach is to enhance your website by creating compelling and informative content that draws in potential clients. Each webpage on your website should be speaking directly to your ideal client, showing them not just HOW you help, but WHY you are the best person to help them. In my Solo Private Practice Startup Bundle, I have a 60+ minute in depth video lesson exclusively dedicated to website creation and copywriting.

Additionally, having a standout profile on directories like Psychology Today, Therapy Den and Google My Business can improve visibility and credibility for your practice. These directories allow individuals to easily find and learn more about your practice, including services offered and client reviews.

Having an optimized profile with professional photos, detailed descriptions, and relevant keywords can further enhance your online reputation. Positive reviews on these platforms can also help build trust with prospective clients and showcase the quality of care you provide. Additionally, being listed on multiple directories can improve your practice’s overall searchability- making it easier for clients to discover and contact you.

My best tip for directories: regularly updating your profiles with fresh content can demonstrate professionalism and dedication to your practice. You have no idea how many therapist are using headshots that are 10+ years old. Something as small as having an up to date photo is a great ways to build trust with your client when you meet face to face for the first time.

Overall, investing time and resources in these marketing tactics, you can successfully grow your client base despite not accepting insurance.

Wrapping it up! 

In conclusion, breaking free from insurance panels requires careful consideration and strategic planning. It is crucial to thoroughly review and understand the terms of your insurance panel contracts before making any decisions. Emphasizing excellent customer service, identifying your ideal customer, gradually reducing your reliance on panels, and leveraging referrals are key strategies for a successful transition. By following these tips and approaching the process thoughtfully, practitioners can navigate the challenges of leaving insurance panels with confidence and build a thriving practice that aligns with their goals. Remember, taking proactive steps and seeking guidance can help you make informed choices as you strive to ditch the insurance panels and achieve greater independence in your practice.

Lets make this super simple: Pick 2 things you can do TODAY to get your practice primed for accepting out of network clients.

My recommendation on where to start:

1. Set up/Clean up your Google My Business Page (making sure you are early found when people search “therapist near me’)
2. Pick an ideal client population to declare as a specialty.

Remember, if you are looking to increase your private pay caseload but are overwhelmed as to where to start, I am happy to sit down with you one on one and come up with a personalized marketing strategy in a coaching session. More details on my coaching packages can be found here.