NETherapist

What Makes You Unique as a Therapist?

2013-12-13T11:39:00.001-06:00

When prospects are searching for a therapist, they really want to know, “Why should I choose you instead of someone else?” How are you different?

Develop your brand in such a way that it could only describe you.

Ask yourself: Would another therapist be able to use this brand?

What makes you unique as a therapist?
You can begin by answering these questions:

What kinds of clients do you most enjoy working with? (Teenagers? Senior citizens? Men, more than women?)
What training do you have to qualify you to specialize in a specific area? (Are you an EMDR Level II therapist?)
What life experiences have you had that would be valuable to others? (Are you a step-parent, for example)?
What makes you different from other therapists? (For example, English isn’t your native language or you know American Sign Language.)
What is your treatment philosophy and theoretical orientation? (Do you incorporate mindfulness principles into your therapy?)
What do you see as possible for your clients? (i.e., Stop Smoking Forever)
What role might you play in helping your clients achieve those results? (A guarantee?)
Is there an area where you are better than others? (Do you you have more experience and training in hypnotherapy than other therapists?)
Is there an opportunity to serve a specific market that no other therapist is reaching? (The Sudanese population, or hearing-impaired clients)
Where could you be the first in the market? (Introducing a new therapeutic technique, for example)
Is there a specific result you can deliver? (Assessment and preparation for bariatric surgery or completion of a court-approved anger management program.)

Want more resources on how to brand yourself as a therapist? Purchase the Therapist's Guide to Branding Yourself Online.

So You Want to Know If You Should be on Twitter

2011-08-20T10:48:00.001-05:00

A therapist asked me what the point of Twitter is, and this is my long-winded response.

Twitter requires engagement. If you don't spend at least 5 minutes a day "managing" your Twitter presence, you won't get a lot out of it.

(The therapist had protected his tweets -- meaning you have to get his approval before you can see what he's tweeting. I don't recommend this. Here's why:)

Protecting your tweets limits your engagement ... these two articles (especially the 23-slide presentation in the second article) spell out why you shouldn't protect your tweets.

http://www.laurenkolbe.com/top-four-reasons-you-shouldnt-protect-your-tweets/

http://social-media-university-global.org/2010/08/more-good-reasons-to-not-protect-your-tweets/

Protecting your tweets is like going to a party and listening into all the people's conversations, but not talking to any of the people unless they ask permission first. "Hey, Terry. Is it all right if I start talking to you now?" Jump right in! And let other people jump in and see what you're sharing too.

Most people find they get more "out" of Twitter than they put "into" it -- that is, it's a unique resource to identify ideas, people, and information that you won't find elsewhere. For therapists, I don't recommend trying to connect with potential clients on there (although there are certainly numerous therapists who have developed substantial followings and clients from Twitter), but instead use it to keep up on resources and quotes that you can share with your clients, followers (just Retweet the info you find), and share across other social media platforms (i.e., your Facebook business page).

You can see who I'm following in the therapy world here:

https://twitter.com/#!/netherapist/following

Sometimes you'll come across things that are really interesting -- like this cartoonist, which I found on Twitter:

http://talesoftherapy.wordpress.com/2010/09/30/worms-therapy-tales-79/

Also -- Twitter has a pretty high visibility ranking for Google searches, which again helps your "know, like, and trust" factor when prospective clients Google you. (And they *are* Googling you...)

You can also connect with the media on Twitter; follow them, and they are likely to follow you back. I've made some great connections for clients on Twitter by following media folks who are on there.

Here are some therapists to emulate:

@ChildPsych

@ANormalShrink

@DaveMSW

@PeterBrownPsy (although you don't have to be as prolific a Tweeter as he is)

Don't be like these people:

@FinktheShrink (holla to all my peeps! Oh, and here's my website. And here's my website again!)

@DCAssociates (they were doing well for about 3 months on there, and then their last post was July 2010)

3) If you really don't want to monitor another channel, don't be on Twitter. It does require work (5 minutes a day or 20 minutes a week will do it) to get value out of it.

You could consider just linking your Facebook business page to your Twitter account and it will post new content when you post a status update to that page. Then, you can spend 5 minutes a day monitoring your account -- following new people (the "Who to Follow" tab at the top will give you recommendations), checking to see if any of your stuff has been Retweeted (click the "@Mentions" tab), and reading the most recent 30 or 40 tweets in your Timeline, retweeting anything you liked.

What are your thoughts on Twitter?

Save the Date - NCA Conference

2011-08-16T13:39:00.001-05:00

Put Sept. 21-23 on your calendar and save the date for the annual Nebraska Counseling Association (NCA) conference. More info to follow...

Omaha Integrative Care for Fertility -- Opening This Fall

2011-07-01T09:26:00.000-05:00

Opening in August is the Omaha Integrative Care for Fertility, a multidisciplinary health care facility targeted to individuals and couples struggling with infertility issues.

The center's focus is on "Mind, Body, and Wellness," offering individual, couple, and group therapy, yoga and physical therapy, acupuncture, nutritional counseling, massage, and continuing education programs.

The facility will be located at 1812 N. 169 Plaza. The phone number is 402-934-1617. Their website is www.omahaicf.com.

Therapist Julie Luzarraga, LICSW is one of the practitioners involved in this new venture.

Guest Post: Improving Your Online Profile

2011-06-22T08:13:00.000-05:00

By Michele Pariza Wacek

The moment I decided to specialize as a direct response copywriter (which means you get a response directly from the marketing materials, there’s no middle person involved, like a sales rep) I knew there would be one thing that would determine if I would be eating steak or eating mac and cheese.

And what’s the one thing? The results I got for my clients.

Therefore, improving results became a pretty big focus of mine. You might even call it a passion. And that’s why today I want to share 5 tips that can help you improve the conversions of your marketing materials. (Conversions means the number of people who buy — how many people convert from leads to buyers.) You can use these tips to improve your online profile (for example, your Therapy Directory profile.)

1. Know who you’re talking to. If I hear anyone say “women are my potential customers” or “anyone with skin is my target market” (yes, that really was a direct quote from someone who sold Mary Kay or Arbonne or something like that) I will send my border collies (both of them) to your house and force you to play fetch with them until your arm falls off. Seriously, the quickest way you can end up with the most dismal results imaginable is to try and talk to everyone. Come up with a specific customer — the more specific the better — and make sure your marketing materials speak directly to that customer.

2. Make sure you write benefits, not features. This one is probably the hardest one to “get” but also one of the most critical. People buy benefits, not features, so if you only talk about features you’re just asking for people not to buy what you’re selling.

So what is the difference between features and benefits? Features are a description of a product — for instance, if we’re talking about a diet pill, a feature would that the product is a pill. A benefit would be the solution the product provides — in this case, losing weight.

As much as you possibly can, write about why someone should buy your product. No one buys diet pills because they like taking pills, they buy them to lose weight. Think of the solution your product or service provides and write about that.

3. Work on that headline. David Ogilvy, famous ad man and author of Confessions of an Advertising Man, has said that people make the decision to read your marketing materials based your headline.

Your headline should: a. speak to your potential customers, b. contain a benefit, c. be so compelling your target market is compelled to read further. That’s a lot to ask for from basically a handful of words. So don’t rush the process — take as much time as you need to create the very best headline for your particular piece.

4. Don’t forget the call to action. You’ve got to tell people what to do next. If you don’t tell them what you want them to do, chances are they won’t do anything.

Don’t assume your potential customers know what you want them to do. They don’t. They can’t read your mind. Nor do they want to. They’re busy people. They don’t have the time or the energy to figure things out. Tell them what to do next, or don’t be surprised when they don’t do anything.

5. Use P.S.’s or captions. Postscripts (P.S.) are the second most read item in a sales piece. What’s the third? Captions. (The copy under photos, diagrams or other illustrations.) Now that you know that, think of the ways you can use either or both of those items in your pieces. Maybe you put a special offer in there or you highlight a particularly compelling benefit. Or you tell them again what you want their next step to be. Whatever you do, don’t waste that space.

If you even do just one of these tips, you should start seeing better results. Work on all five and you might be amazed at how much your results improve.

About Michele: Considered one of the hottest direct response copywriters and marketing consultants in the industry today, Michele PW (Michele Pariza Wacek) Your $Ka-Ching!$ Marketing Strategist, has a reputation for crafting copy and creating online and offline marketing campaigns that get results. Michele started writing professionally in 1992, working at agencies and on staff as a marketing/communication/writing specialist. She started Creative Concepts and Copywriting LLC in 1998 and has never looked back.

Marketing Your Practice - Part IV

2011-06-21T07:32:00.000-05:00

Here’s how to find out if a specific marketing strategy is working for you:

• First of all, what do you spend per month on this marketing tactic (either in terms of money, or time, or both)?

• Do you track new client referral sources?

• How many inquiries per month do you get from this marketing source? (You probably only track how many become clients, not total inquiries.)

• How does the number of new clients from this marketing source compare to a year ago?

• What your the top referral source overall? How does this tactic compare, in terms of number of referrals?

• Do the kinds of clients I get from this marketing source match my “ideal” client profile? Do I enjoy working with these clients?

• Are these clients profitable? Do they pay, on average, a reasonable fee for the services?

Next, do some simple math. Multiply the number of clients you got from that marketing strategy last month times the number of sessions you saw them times a reasonable fee (what you actually get paid, not what you charge).

For example, you might have gotten two new clients from the Yellow Pages last month, and saw the clients a total of 4 times. You charge $100 an hour, but collect an average of $85. So take 85 x 4 x 2 = $680.

Next, look at how much you, individually, spent on your Yellow Pages ad last month. Let’s say the ad costs $475 total each month, and you and the other therapists in your practice split it 4 ways. That’s about $120 for your investment.

Your return on investment is 11-to-1 ($680 + 120 = 5.66).

Your return on investment (or ROI) should be at least 5-to-1 for any advertising you do.

If you’re not getting at least a 5-to-1 return on your Yellow Pages investment, you can do 2 things:

– Improve your Yellow Pages ad by redesigning it

– Spend the money elsewhere

Marketing Your Private Practice - Part III

2011-06-20T07:31:00.000-05:00

You are already successful in getting SOME new clients, otherwise you wouldn’t be in practice, right?

But are you getting the right kind of clients? Ones that appeal to your clinical skills and strengths? Ones that can pay your fees — or whose insurance lists you as a preferred provider?

My goal when working with therapists is to help you identify what you’re already doing well that attracts your ideal clients and to encourage you to do more of that — but to do it consistently, so you don’t have that “feast or famine” look to your appointment books.

The temptation is to take as many billable hours as you can right now and worry about marketing later, but that’s exactly what leads to feast or famine.

The problem I find with most therapists is that when you put something on your to-do list that has to do with marketing, you’re the only one making sure it gets done. If a client emergency comes up, marketing is what suffers. That’s okay once or twice, but marketing has to be a priority — you need to be consistent. It’s better to do one thing consistently than to do four or five things only once.

I conducted a survey of therapists recently and found that the majority of therapists responding spent one hour EACH MONTH on marketing their practice. That's not really enough to build your brand. An hour a week will get you closer to filling your practice.

Some therapists nationally have done an excellent job creating their personal brand. Their name is synonymous with the work they do. What kind of work do these therapists do?

– Dr. Ruth [sex]

– Michele Weiner-Davis [relationships]

– Frank Pittman [affairs]

You can either build your brand yourself, or capitalize on a national brand … especially a well-known one. For example, you might be “Omaha’s Dr. Ruth.”

Even if you only want a handful of new clients each month, you can attract your ideal client by conscientiously choosing what kind of clients you want to work with, and using some specific strategies to attract those kinds of clients.

For example, if you want to work with clients on stress management issues and you like the way Blue Cross Blue Shield (BCBS) insurance reimburses, put together a brown bag lunch talk on “Reducing Stress on the Job” and pitch it to an employer who has BCBS as their insurance provider.

Marketing Your Private Practice - Part II

2011-06-18T07:29:00.000-05:00

C.J. Hayden, in her book “Get Clients Now!,” outlines the six basic methods you can use to market yourself:

– Direct contact and followup. Look at who has referred to you in the past. Call and ask if you can take them to lunch to thank them and learn more about how you can help the people they know.

– Networking and Referral Building. If you specialize in infertility counseling, for example, you should get to know a couple of different audiences. The first is infertility docs. They are going to be your number one source of referrals, likely. The second is OB-GYNs in general, with general practice physicians coming in after that. You’ll want to find out if there are any local chapters of support groups, like RESOLVE. You might also want to connect with local pastors or ministers, who might work with parents who lost a child during birth, or before. Send them a letter and business card and then call to follow-up.

– Public Speaking. Look for opportunities to speak and educate prospective clients — which also increases your visibility with referral sources. Or, look for opportunities to speak to groups of your referral sources. Every therapist in the state has numerous opportunities to speak at professional association meetings. Whether you’re speaking to the public or peers, make sure you create a handout with your contact information; have plenty of business cards on hand; and have a drawing or sign-up sheet so you can collect people’s contact information.

– Writing and Publicity. Article writing is another way to increase your visibility. You can write articles to publish on your website, your blog, or for publication in newsletters — for example, association newsletters, or group newsletters. If your area has chapters of national organizations, like CHADD, they are always looking for content.

– Promotional Events. Consider hosting a luncheon for a group practice of physicians. These types of events aren’t limited to pharmaceutical reps. Call the local practice and ask if you can bring in lunch and introduce yourself. Or participate in local community events, like health fairs or outreach events. You can host events for prospective clients or referral sources, or both.

– Advertising. Finally, there’s advertising. This encompasses everything from newspaper and magazine ads to Yellow Pages, direct mail, and much, much more. Advertising won’t get you the results that some of your other efforts will, but it can help increase your visibility and name recognition.

Marketing Your Private Practice - Part I

2011-06-17T07:25:00.001-05:00

I often say in my marketing presentations that there is no secret formula or magic bullet to filling your private practice — the key to success is to select a few simple tactics and do them consistently.

I like to use the model developed by C.J. Hayden, author of “Get Clients Now!,” to help you understand how this works. Marketing is like a water system; it’s constantly “in flow.”

You start with buckets of prospects, contacts, leads, and referrals. The first stage is filling the pipeline. The second stage is following up. Then you get to the third stage — which is the “presentation” stage. For therapists, this is usually a phone conversation. Prospective clients either say “yes” or “no.” Yes is they book an appointment. No is “I’ll get back to you” or “No thanks.”

The key questions to ask yourself are: Where in this cycle are you stuck? Which stage needs more work? Do you need more people contacting you? Do you need help getting them to the point where you can talk on the phone for five minutes to see if what they need and what you offer is a good fit? Do you need help following up with folks who don’t say “Yes” right away?

Do you consistently capture the names and e-mail addresses of people who contact you? Few therapists bother to build a database of prospective clients to keep in touch with until they say yes. Even fewer actually keep in touch with those prospects. Yet it’s easy to send an informative quarterly e-mail newsletter to prospective clients who contacted you at one time.

There is also a mathematical formula at work here. The general guideline across all industries is that you need 30 people in your pipeline to yield 1 client. Because therapy clients “self-identify” themselves for the most part, I believe the ratio for therapy clients is actually closer to 6-to-1. For every 6 people who find you, one will become a client.

In order to effectively build your private practice, you need to cultivate relationships. These can be relationships with prospective clients, referral sources, insurance companies, EAP providers, or anyone else in a position to either become a client or send new clients your way.

Build your visibility in order to be in touch with enough people to convert into clients. To gain visibility, you need to market yourself.

Marketing is telling people what you do, over and over again. It’s a process where prospective clients get to know, like, and trust you.

Therapist Profile - 2011

2011-06-16T22:54:00.002-05:00

Are you interested in getting more client referrals? Dozens of therapists have found that The Therapy Directory (powered by Psychology Today) can provide you with new client referrals.

Interested in learning more? Use my promotional code to receive a free 90-day trial of The Therapy Directory, and see for yourself! (Use this link: http://www.tinyurl.com/DBL84B)

Want to build a profile that is a virtual client magnet? I've prepared a presentation, "Building Your Online Therapist Profile" that will help you develop your listing on The Therapy Directory.

You can listen to the recording of the teleseminar using Itunes
OR
Download a transcript of the teleseminar recording.

Want to check and see if your vanity URL is available? Click on the 1&1 banner below and search for the domain you're interested in registering.

Or click here: http://www.tinyurl.com/netherapist

Looking for more help with developing your profile?

Purchase the "The Therapy Directory Sign-Up Kit." For just $49, you'll receive:

A sign-up kit to receive your free 90-day trial to The Therapy Directory.
One-year registration of a vanity URL to re-direct to your Therapy Directory profile.
15-minute consultation with Bridget to review and revise your Therapy Directory narrative.

If you don't want to purchase the Sign-Up Kit online, you can fax or mail your credit card information to us and we will e-mail you the Sign-Up Kit as an Adobe Acrobat PDF.

Ready to write your own profile, and don't need the URL or consulting assistance? Sign up for your free 90-day trial of The Therapy Directory here.

Want to learn more about creating your online identity? Purchase the "Therapist's Guide to Branding Yourself Online," an e-book by Bridget (Weide) Brooks for just $19.

For more information on developing your brand:

Once you get your profile up on The Therapy Directory, if you have a fairly "general" profile (not targeted to a small niche, like trauma work), you should be receiving approximately 100 views to your profile per month, and 1-5 clients per month. If you're not getting those kinds of numbers, contact me.

Updating Office Space Listing

2011-02-11T14:30:00.001-06:00

I've had several requests for updated information on office space available for therapists (both joining a practice as well as renting space) since publishing the original post in July 2010.

Here is a practice opening I just received:

Office available in gorgeously built-out suite of five offices. Waiting room capacity of 10. Private exit (to avoid entering/exiting through waiting room). South-facing window in 13x13 room. Includes kitchen, bath and shower, storage, fax, and copier. Simple rent. 15 minutes from anywhere in Omaha. Located in the heart of the city (76th & Pacific). Share space with four other mature therapists. PLMHPs welcome. Contact Steve Abraham, LIMHP at (402) 707-0788 or via e-mail.

If you have openings (or are looking for a practice to affiliate with), contact me.

What's Your Job Profile: Gina Fricke

2010-09-05T13:02:00.000-05:00

Therapist Gina Fricke, of Peace and Power Counseling, was included in a "What's Your Job?" roundup feature in the Sunday, Sept. 5 edition of the Omaha World-Herald.

Therapist Survey: Subleased Office Space (Part 4)

2010-08-19T09:22:00.100-05:00

This is the fourth post in a five-part series of articles based on a July 2010 survey of therapists regarding office space subleases. Previous articles examined fees and amenities offered, an analysis of factors related to deciding which practice to affiliate with, and how referrals and emergency coverage issues are handled.

The most useful part of the survey was the advice given by therapists about renting office space. Experience is the best teacher, and therapists participating in this survey have either rented space from another therapist, or are a "landlord" themselves, renting space to other therapists (or, in some cases, they have experience on both sides of the equation).

Therapists provided guidance for what questions to ask/issues to consider when subleasing space:

What does my rental fee include? (Billing, scheduling, referrals, consultation group, marketing, inclusion on practice website?)
Ask about additional fees up front: Are any fixtures to be added or modified, and who will be responsible for paying this fee?
Ask for a full disclosure of costs for the space and for how much profit the therapist will make from the rent/fees you will be paying them.
"Consider sharing space with other independent therapists over renting space from a therapist. The costs can be cheaper, there is more equality in decision-making, there are no hierarchies, and there is full disclosure about what you are paying for and what you are getting."
Will I be getting referrals?

A couple of therapists provided their ideas of a "model" situation:

"I would want 100% of my counseling fees and pay a monthly rental fee. I would pay per referral, if referrals were given to me. I would not sign a non-compete, because clients ethically should not just be handed over to someone else if I decide to leave. I would want a very explicit plan for how call-ins to the office were handled, and how I would know that my calls would be mine. Personally, I would want my counseling philosophy to 'gel' with others in the office."
"Try to get office/secretarial support, telephone, and a couple referrals per month."

"It may be helpful to start out renting space from another therapist when learning the ropes of private practice, but it is important to know exactly what is entailed in the contract, how decisions will be made, and what actions will be taken to address concerns about the space or services," one therapist wrote.

Others gave advice on which issues to focus on when selecting a practice to affiliate with:

"Check for compatibility of clientele and for confidentiality issues."
Look at the general style of the office (culture, feel, fit)
"I have done a percentage before, but I believe a flat fee is best, because you know how to plan."
"Each therapist should share either similar values, or be compatible. They should know the reputation of the persons they are renting with or to/from. When sharing with several people, they all should get a say about who might also join the practice."

It's important to examine the whole financial picture, not just the rental fee.

"Private practice has many hidden and unforeseen costs: legal, accounting, consultation, and practice building." Consider these when choosing a practice as well.
"Compare costs and what that cost gets you in amenities."
"A private practice is a business, and to assume that one gets referrals just for being there is naive. Business development is complex, time-consuming, and costs money."
"Remember that going out on your own can be challenging too. If you share office space or a building, you can share office equipment, phones, and Internet. This can save you a lot of money. Not to mention electricity and office materials, such as paper towels, etc. In the office I am in, I do not have to clean the office either, as this comes along with the rent."

One therapist provided an innovative suggestion: "If you start with a percentage arrangement, make a cap and change to a flat monthly fee once the cap is consistently reached for six months to one year." This will help the renter decrease his or her overhead as he or she gets more successful.

Be sure to ask about how referrals are handled.

One therapist noted, "I was fortunate to have a large referral base prior to coming to this office, and I had a lot of referrals that went directly to me. Sharing referrals can be challenging if you are just starting out, but as you continue to build your referral base, people will begin asking for you. In a shared office, this can be challenging, as everyone wants to have business."

One therapist recommends a careful self-analysis before seeking a practice affiliation. "Where are they in their profession? What is needed? How much time do they want to make available to do the support work, marketing, and business development?" Ensuring you select the practice that provides the services you need/expect will make the arrangement a beneficial one for both the subleasing therapist and the practice or "landlord therapist."

Another therapist cautions peers not to simply limit their focus on the financial aspects of the selection process. "By far and away it is most important that you know and trust the personal and professional ethics that the other therapists have in the office you are using. Everything else comes down to money, and that's not as critical."

Compatibility is key. "It is important to know the therapists, or at least talk to them in depth, to see if your personalities are a fit." Another therapist added, "Don't rent from a therapist who wants to tell you how to do therapy. I have never had that problem, but others have."

"Know the dynamics of the other partners with whom you share space. Seek quality, ethical concerns, and professional compatibility. Being picky is best."

Several therapists advised getting the contract terms in writing. "Read it carefully and compare it to either past contracts or standard ones," one noted. Another added, "Get everything in writing, and have each therapist sign it. This prevents misunderstandings and complications at a later time." Make sure the contract notes the specific rights and responsibilities of each party. "Read the contract! Know exactly what you are getting."

And get everything hammered out up front, if possible. "Negotiate before signing; doing so afterwards gets thorny."

Even finding the perfect office sublease situation, getting into private practice can be difficult, as one therapist reminds us. "You need to be fully licensed, in network with many insurance providers, and have a good base of clientele you might bring with you. Even with that, it is difficult for about a year to make any money."

One concluded, "I've been very fortunate, but it's important to have a contract with those in the same office so that all expectations are understood by all."

Therapist Survey: Subleased Office Space (Part 3)

2010-08-18T09:18:00.003-05:00

This post reports additional results from a survey conducted in July 2010. Previous posts have examined the costs and amenities available when renting office space and the issues therapists consider when selecting a subleasing arrangement.

One issue for contracting therapists is access to referrals, especially in a large practice. Unless the therapist has his or her own clientload -- or can build one independently of calls into the practice, renting space can make it difficult to attract clients.

Forty-one percent of therapists renting space had access to referrals within the office as part of the rental fee. One-third of therapists surveyed did not have access to internal referrals. Another third received referrals on a case-by-case basis.

When asked about referrals, some responses included:

"Referrals are not part of the rental fee. However, referrals are frequent."
"They go to partners first and then to contractors."
"Referrals (are) provided as appropriate for patients, not as part of fee."
From a therapist who rented space to other therapists: "If referrals were specifically for me, I kept them or referred them; other referrals were divided up by therapist/renter."

Another key issue is emergency coverage. In nearly three-quarters of the situations, no on-call services are provided for any therapists -- each therapist provides his or her own emergency coverage. In 13% of the situations, renter serve as an on-call therapist for clients (all therapists in the office rotate providing emergency coverage). Ten percent of therapists had access to emergency services through special arrangement:

"My rent is adjusted slightly to include on-call service for my clients."
"No coverage for purely renting space, but it would be possible if interdependence desired."
"Phone coverage includes message service to contact each therapist in case of emergency.

Therapist Survey: Subleased Office Space (Part 2)

2010-08-17T09:07:00.025-05:00

This is part 2 of the results of a July 2010 survey of therapists regarding office space subleasing. This post examines issues of deciding which practice to affiliate with.

Therapists have a choice of where they want to rent space. Some factors cited in influencing their decision about where to rent space include:

Location -- interstate access; the part of town the office is located in, etc. -- 15%
Rental cost -- 15%
The therapists you would be working with -- 14%
The "general feel" of the arrangement/office -- 13%
Site accessibility (i.e., handicapped accessible) -- 10%
Layout of office -- 9%
Security -- 6%
Amenities available -- 5%
Reception area -- 4%
Marketing availability -- 3%
Availability of administrative support -- 3%
Availability of billing services/support -- 3%

Most therapists choose to affiliate with other mental health practitioners. However, in addition to renting from other mental health therapists, a few therapists rented space from other types of practitioners, including a psychiatrist and a doctor's group.

The next post in the series examines how referrals and emergency coverage is handled when subleasing space.

Therapist Survey: Subleased Office Space (Part 1)

2010-08-16T07:55:00.011-05:00

Are you a therapist who is interested in renting office space -- or are you a therapist who has space available for rent? A July 2010 survey of therapists reveals pricing and amenity details, and participating therapists give advice on making an arrangement work for you.

The survey was completed by 39 therapists. Nineteen percent of respondents have rented space from a non-therapist landlord; 38 percent have rented space from another therapist. To provide a balanced perspective, 32 percent are therapists who rent (or have rented) space to other therapists (a "landlord's view). The majority of responses (75%) came from Omaha-area therapists.

When it comes to fees, it is difficult to compare apples to apples. However, from the information supplied, a few general conclusions can be drawn.

Part-time rentals generally are in the $150 to $750 per month range. Full-time rentals most often cost $1,000+ per month. The overall average (including both part-time and full-time) rentals was $726 per month.

Most space is rented for a flat fee, although a small percentage (25%) of respondents reported their rent is a percentage of the session fee billed or collected. These figures were more consistent -- the most-often cited figure was 35% of the amount collected. Other options were 30% of the amount billed, and 1/3 of the total office rent.

There was insufficient data on hourly rental rates to draw any conclusions.

In exchange for the rent, therapists generally receive:

Exclusive use of a private office (12%) vs. shared office space (5%)
Administrative support (6%)
Billing services (7%)
Access to conference room/meeting space (8%)
Copier/Fax (11%)
Consumables, like office supplies (8%)
Participation in marketing/advertising (8%)
Telephone (11%)
Internet access (10%)
Checking patient insurance benefits and/or securing insurance authorizations (9%)
Access to emergency coverage (5%)

Therapists are generally required to carry their own liability insurance when renting space. However, in some circumstances, liability/property insurance was included.

Some rental agreements offered some flexibility in services offered. One therapist reported their agreement was based on the "percent of overhead used," what supportive services were included, and whether marketing was needed.

Next post: Selecting which practice to affiliate with.

Links to Billing Teleseminars

2010-08-15T10:52:00.001-05:00

You can find information about Billing Questions Teleseminar #1 (June 9) here and Billing Questions Teleseminar #2 (July 14) here. Please note that the Billing Questions Teleseminar that was scheduled for Aug. 11 was cancelled due to an injury to the guest speaker.

Why Online Directories Are A Smart Investment

2010-08-14T11:02:00.001-05:00

Why should you advertise your private therapy practice in an online directory?

This is a question that I'm often asked by therapists. "Shouldn't I develop my own website and get clients to find me online where I'm not surrounded by all the other therapists who do what I do, or work where I work?"

Absolutely you should have your own website. And an online profile in a directory can help drive clients to your website. It can also spur calls to your practice directly, from clients who like your profile and need help immediately.

The second concern is the idea that if a client is looking for a therapist online, he or she will not choose YOU; instead, he or she will choose another therapist. That is a very real possibility, obviously. However, if you use the personal branding concepts I've talked about before on this blog (and wrote about in my book, "Therapist's Guide to Branding Yourself Online"), you'll attract the kinds of clients you most want to work with.

People often choose directories because of the variety they offer. You know you're going to get access to a range of service providers -- but there is bound to be one that feels like a fit. The Yellow Pages work because there are a lot of companies in there. It wouldn't be used as much if there were only 2 plumbers listed, or 1 attorney.

Today's Billing Teleseminar is Cancelled

2010-08-11T14:46:00.001-05:00

Today's billing teleseminar is cancelled. Our guest, Deb Winsor, was a victim of a physical assault and will be unable to make today's call.

Billing Questions Teleseminar #2 (July 14, 2010)

2010-08-06T15:51:00.002-05:00

The second Billing Questions Teleseminar was held on Wednesday, July 14, 2010.

Download the .mp3 audio file here.

(You can find information about Billing Questions Teleseminar #1 (June 9) here.

Our guest was Deb Winsor of W-Tech Solutions. Here is an abbreviated transcript of the call.

Bridget: Thanks so much for joining us today for “Billing Questions,” your chance to get your mental health billing questions answered.

My name is Bridget (Weide) Brooks, and I’ll be your host for today’s call, which is sponsored by w-Tech Solutions Inc. and TherapySites.com.

This is our second teleseminar call, and I’m thrilled to be able to offer therapists the chance to ask questions of our distinguished guest, Deb Winsor, of W-Tech Solutions. A little background on Deb: she has a bachelor’s degree in business administration from the University of Nebraska Lincoln worked in a hospital setting for more than five years before joining what we call an extremely well-known insurance company here in Omaha, where she has worked for the past 11 years. Deb has experience with Medicare, Medicaid, managed Medicaid, PPO insurance, Tricare, and numerous other insurance companies and she has a wealth of information to offer to therapists who have questions about billing or insurance. Her company, W-Tech Solutions, provides billing services to mental health therapists. Welcome, Deb!

Deb: Thank you.

Bridget: So, just like last time, first off, I wanted to let the therapists who are participating live on the call ask their questions, and then we’ll get to the questions that were submitted by therapists via e-mail. So if there is anyone on the call with a question, let’s go ahead and take it now.

Caller #1: My question is how much transferability is there between how Medicaid in Nebraska handles claims and requirements versus Medicaid in other states — particularly Kansas? My office partner and I are both located in the greater Kansas City area.

Deb: My first question is: Do you have any patients that have Nebraska Medicaid?

Caller #1: No.

Deb: So your patients have Kansas Medicaid? Correct?

Caller #1: Will have. Right.

Deb: Each state has their own program. It’s on a state-by-state basis. But I am trying to find on the web if there is any kind of provider line for you.

Caller #1: We’re both in the process of applying for (Kansas Medicaid). I was a (Medicaid) provider in Nebraska. I think we probably have the provider line (number).

Deb: So you are in the process of setting up your provider status with Kansas Medicaid, and you’ve contacted them. The paperwork is in the mail.

Caller #1: And (my office partner) has been a Kansas Medicaid provider in other situations (with other employers).

Deb: So they’re going to send you a packet of information and assign you a specific number. Once that is done, they will send you a letter of acceptance, stating that you are now eligible to see this type of patient. You should be able to file claims electronically to them. As far as that is concerned, the billing itself is just a different location, but it’s the same CPT codes. You fill out your HCFA 1500 form the same way, and you shouldn’t have any problems. I would just say make sure you cross your “t”s and dot your “I”s and you shouldn’t have a problem. But any questions with them, contact their office.

Bridget: To answer the caller’s question also, each state administers their own program, so while federal guidelines are the same, each state is allowed to contract with its own providers, for example, with Managed Medicaid, so that’s where you’re going to get a little bit of discretion for how things are authorized, paid, and that sort of thing. If Magellan is administering the Medicaid in Kansas, you might see that a lot of their policies and procedures are the same (as in Nebraska), because they don’t want to duplicate efforts across the different states, but if it is a different provider – Coventry, or some other one — that’s when you’re likely to see a little bit of difference between how they do things. I know Magellan and the state of Nebraska right now are working to clarify some of the service definitions in particular in Nebraska, and there has been a little bit of back and forth on that on how they’re clarifying certain things and how they want to handle medical necessity and those sorts of things. So probably the first step is to find out who is administering Medicaid and that might give you some sort of insight into how much will be transferable.

Caller #1: We’re in the process of applying for Tricare – I think it was Tricare -- and (my office partner was) told that they were holding off on accepting new applications, but that she could be a “pseudo-provider,” which was a new term.

Bridget: I’ve never heard of a “pseudo-provider” before. What kinds of rights and responsibilities does a pseudo-provider have?

Caller #1: Well, that’s what we didn’t know. We didn’t know if there was a “pseudo-provider application” – but I wondered if you were familiar with this term. She was told she could go ahead and bill as if she was a provider, but I wondered if you had heard of this.

Deb: What is her credentials?

Caller #1: She is a licensed, master’s-level psychologist, so “LMLP.”

Deb: I have never heard that term (“pseudo-provider”) before. Usually, with Tricare, you have your Tricare Prime... Be very careful with Tricare. They are very good about paying, but make sure you have your pre-authorizations before you submit for your services because if you don’t have your authorizations, they will either deny, or they will pay at a much lower benefit. Also, for the member (for out of network services), they have a much larger deductible rather than a certain dollar amount of a copay.

Bridget: That might be a good question to call the provider relations folks and ask them.

Deb: I would call their provider line and ask them about that. Because the first thing that came to my mind was maybe that it was like a PLMHP that was submitting under an auxiliary provider.

Caller #2: It didn’t seem to be about my licensure, it seemed to be about having me be part of a group that was already established. She (the provider relations rep) didn’t explain it well.

Bridget: So it seemed to be part of a network provider issue rather than a credentialing provider issue.

Caller #2: Right.

Bridget: I am Googling the words “Tricare” and “pseudo-provider” and they use the word “pseudo” a lot, so I think they like that word.

Caller #1: I hope they don’t send “pseudo-payment!”

Bridget: I agree with you! They talk about “pseudo sponsor IDs” and “pseudo social security numbers” — so specifically what they are referring to in terms of your responsibilities would be a great question for your provider relations representative. Ask them: What distinguishes me as a “pseudo” from a “real”? I wonder if maybe it’s that their network is pretty full, but they don’t want to turn you down flat, just in case they need you later.

Deb: They might have restrictions on how many providers they can actually have on the panel. I’ve seen that before, once in a while. Like a waiting list.

Bridget: So you can see them, but maybe it’s on a case-by-case basis. But I agree with Deb, you want to make sure you’re approved and pre-authorized for specific sessions and clients before you see them… because “pseudo” or not, you don’t want that “pseudo-payment.”

Deb: I am going to do some research on this, and I’ll send Bridget my findings. I would love to give you a definite answer. I pride myself on getting the right answer, and I want to find the right answer for you before I give out any information. Let me research it and I will give Bridget an e-mail and have her forward it on.

Bridget: Next up are questions we received via e-mail from therapists who weren’t able to make the call live, but wanted to get their questions in.

Question: Do the CPT codes for home visits have a certain time frame, and if so, are they 15-minute increments, like health and behavior interventions?

Deb: I have researched this, and I have personal experience with this too. The answer to that would be, the information I have is that you should just bill as if you were in the office. You can use your 90806s, 90801s as if you were in the office. You would bill the same as if you’re out of the office at a patient’s home. I can tell you from experience, when we moved to our current home, my son was little at the time and he was having a little harder time adjusting, so we had a very nice man come out, an LMHP, and he sat with my son and spoke with him for 50 minutes at a time, two or three times a month. I got to stay in the home; I didn’t have to drive anywhere. He just submitted the regular 90806 to the insurance company, and they paid. It was almost as if we were in the office, just a different location, and it got paid like a normal office claim.

Bridget: So, in general, they would be paid – but, if you had a particular claim, this would be a good question to ask the specific insurance company.

Deb: I would. It’s always good to call if you have any doubts, to ask questions. They are always willing to answer, and you won’t be the first one to ask, and you won’t be the last one to ask. To my (personal) experience — and to my billing experience — you can bill the same code that you would as if you were in the office.

Bridget: And with the same time length.

Deb: Right. If you’re seeing them for 25-30 minutes, you’d bill them 90804, but 45-50, 60-75, use the right code.

Bridget: And that’s face-to-face interaction; you can’t count your driving time.

Deb: Right.

Question: We received this question from a therapist after the first billing teleseminar call: I just listened to the recording of the initial billing teleseminar and am a little confused about using my tax id instead of my social security number on claims. I already have a federal tax id, but was told by my tax preparer that I should use only my social security number so I've billed with it for years. Since I already have the federal id, do I just contact each insurance company I participate with and have my information changed?

Deb: I was glad we got this question. It’s a very good question. My answer to that would be: With regards to privacy (and this is what I was trying to say last time), I am very proactive when it comes to HIPAA and personal privacy. I go above and beyond what is required.

With regard to privacy, any time you can keep you SSN for the purpose of personal tax identification, the better. If you choose to have an EIN (Federal Tax ID), that helps protect your personal social security number information from identity theft and other fraud activities. This is the reason why I was suggesting an EIN during the seminar; as I’m a big proponent for personal identity security, and I feel that an EIN gives you a layer of protection.

If you have an EIN, all the better. It would be great to use that. However, her tax preparer is correct. She can use her social security number but in regards to identity theft, if you don’t submit electronically (if you submit by paper), yes, the post office is safe, but anything can happen. It can just take one minor mistake and your social security number could be out in the open.

I’d like to go on to say: When you sign a contract with an insurance company, you are doing so under some type of identifying number: your SSN or an EIN. If you signed those contracts under your SSN, it can be difficult to switch to an EIN as, in many cases, the insurance company will want a new contract signed using the appropriate identification number (or they’ll want to update your current contract).

You can bill under either identification number; just make sure you are billing using the number used when you signed with the insurance companies. If a claim is submitted using your EIN, but you signed/registered with the insurance company using your social security number, payment of benefits may be extremely delayed or they could be denied.

My personal preference is to use an EIN as that allows you a level of personal security because your personal SSN is not distributed to so many people with whom you do not know. However, since you have been billing under your social security number for so long (this is a provider who had been in business for a number of years), switching to your EIN can be cumbersome. You can call the insurance companies that you are in network or PPO status with and ask to speak with the provider relations and let them know that you are currently using your social security number and ask what the process is in regards to updating that and using the EIN.

It just puts up red flags for me when people are using their social security number for billing. You can do it, but it just scares me to death to have that personal information going out. It’s my personal opinion to use an EIN so that you can be protected. Because it doesn’t mean anything to anyone else but you and the insurance company.

If you’re just starting out, take the extra steps and get the EIN. It’s your choice, but if I were you, and I were just starting out, I would use the EIN to set up my contracts with insurance companies.

Bridget: For therapists who might have started out using their social security number, what are some of the things that the insurance companies might balk at? You said they might want to update their existing contract or they might want to have you sign a new one. Would you maybe run into an issue where they might say, “You can’t do that, because you’d be considered a new provider, and we’re not taking new providers”?

Deb: Well, number one, it depends on the insurance company. As long as you’re an existing provider, they’re just updating information. If you started 10 years ago, using your social security number, the norm was to use your social security number, because we didn’t have the HIPAA laws like we did then. It’s possible they would want you to sign a new contract, because the old one was outdated, but that’s no big deal. It’s nothing to be afraid of. I just wanted you to be aware that they can do it.

Updating your contract can be a good thing too. Some providers are afraid of going electronic. Just making that change, you can get so much information. The insurance company can send you feedback, they’ll send you updates. They can catch things – “We notice you did ‘this’ a lot.” You’ll get newsletters with frequently asked questions. It can turn out to be a much better experience with that kind of information.

Bridget: So billing with your EIN makes it more secure for you to file your claims, both paper and electronic. And, of course, electronic billing opens you up to more recordkeeping and reporting information and resources from the insurance companies, because they want to reduce their costs, so they want to encourage folks to bill online, when possible.

Deb: I want to put out my little disclaimer here. Insurance companies are not always the bad guys. Employers will tell the insurance companies what kind of benefits they want, and there are contracts out there that have no mental illness benefits as part of the policy. That can be from the employer. I go to the pharmacy a lot to pick up my prescriptions and it just really gets my goat when people say, “My insurance company didn’t pay this. “I just want to say to them, “If you have a complaint, you really need to go back to your employer because your employer is choosing those benefits for you.” The same thing for mental illness. Just because you have an insurance company and they’re not paying, it could be that it’s not because of the insurance company – it could be because the employer wants to save some money, or they chose one benefit over another, because times are tough and money is tight. It’s not always the insurance company (at fault). Insurance companies have a lot of experience and they train their people to be ready for your questions and they’re more than willing to answer those questions.

If I get a representative who doesn’t answer my questions, or they’re rude to me, let the insurance company know. They need to know that information. They’re willing to answer your questions. Don’t be afraid of them.

Question: Are there separate billing codes used for transporting a patient from place to place?

Yes. What I found out, and what I’ve seen in the past, from billing, is that for Medicaid, currently the code is 99082. This is a CPT code for mileage. The reimbursement rate for Nebraska Medicaid managed care plan is $.45 per mile, but please note that many private insurance companies do not pay for this item. However, if your client is covered under Medicaid (remember, it’s a payer of last resort, so if the client has another insurance company, you’ll need to get a denial first), you may be able to get reimbursed.

I’d invite you to contact Deb at W-Tech Solutions at 557-8628 or e-mail w-tech_billing@cox.net if you have any billing questions or if you’re interested in working with her. W-Tech Solutions allows therapists to focus on the billing aspect of your business so you can focus on your clients.

Today’s call is also sponsored by TherapySites. You can build a successful online website for your private practice in just four easy steps. In addition to a website, you’ll also receive unlimited email accounts, online appointment request capability, credit card processing, and more – for just $59 per month. There’s no up-front costs, no long-term commitments, and you can get your FIRST MONTH FREE when you use the promotional code PromoIBC when you sign up. Visit www.TherapySites.com and try it for free before you sign up. And be sure to use the code PromoIBC to get your first month free.

The next Billing Questions Teleseminar will be Wednesday, August 11 from 3 to 3:45 p.m.

No More "A Counseling Center, P.C."

2010-07-26T14:33:00.001-05:00

Kevin Fitzmaurice has closed his practice, A Counseling Center, P.C. and is moving out of state. The practice was formerly located at 3323 North 109th Plaza in Omaha, Nebraska.

Using LinkedIn to Cultivate Referral Sources

2010-07-08T10:36:00.000-05:00

Using social networking to fill your private practice is a complex subject. It's filled with ethical issues and lots of decisions (should I have a presence on Twitter? My own Ning group?).

One social networking strategy I do recommend for therapists, however, is LinkedIn.

LinkedIn bills itself as "the world's largest professional network," with more than 70 million members worldwide. It connects you to business contacts and allows you to exchange knowledge, ideas, and referrals. Private practice therapists can use it to grow their business and get practice management advice.

Once you're on LinkedIn, however, the question is: "What do I do now?" I have the perfect book for you. It's called, appropriately, "I'm on LinkedIn. Now What?" by Jason Alba.

The first step, however, is signing up for an account.

Office Space Openings in Omaha, Nebraska

2010-07-05T12:38:00.000-05:00

If you are looking to join an existing private mental health practice, simply rent office space, or switch group practices, there's no better time than now! Several groups are actively seeking new members (or renters), and I've compiled a short list of these here. I also know of a couple of others that are quietly seeking members, so contact me directly at (402) 393-4600 if you'd like to be put in touch with those folks. (I'll give them your contact information.)

Steve Abraham - (402) 398-9055
New office space available at 7602 Pacific, Suite 205. Space includes a bathroom & shower, kitchen, plus ample storage. Price is reasonable.

Steve Brownrigg - (402) 510-1754

Spacious, quiet, well-appointed 270-foot deluxe office space for adult/adolescent therapist. In the John Wear Building at 76th & Pacific. New Berber carpet, ample natural light, new waiting room furnishings, oak trim throughout. New soundproofing (walls and ceilings). Refurbished utility room with fridge & sink. Also offering hourly rental of new office on Friday/Saturday only. $20/session.

Aspire Counseling Services -- Deanna Hanquist -- (402) 502-5030

Two offices available in office space at Terrace Plaza, 11414 West Center Road, Suite 233. Plenty of parking. Interstate access (right off of 680 & West Center Road).

Gina Fricke -- (402) 515-7412

Office available for rent (by the hour or by the day) at 6901 Dodge Street, Suite 101. The cost is $15 per hour or $60 per day. Includes Internet access, desk, and waiting room. No fax, no phone, no computer. Office is handicapped accessible and has a window.

Kairos Psychological -- Bob Kraft -- (402) 330-0800

Opportunity for new independent contractor to join the practice.

Jeff Stormberg -- (402) 393-0642
Office at the Historic Paxton building (14th & Farnam, Suite 215). Includes waiting room, reception area, telephone system, Yellow Pages listing, fax, and public bathrooms (on the same floor as the office). One heated parking stall is included. Ample public (metered) parking available outside building.

Reasons to Join the Association of Private Practice Therapists (APPT)

2010-07-02T08:28:00.000-05:00

The Association of Private Practice Therapists (APPT) invites practicing mental health therapists -- even if they are not yet in private practice -- to join the organization. There are two levels of membership -- Traditional membership is for therapists who are currently in private practice for more than 10 hours per week. Associate Membership is for those who are interested in private practice as a future career (and this category is also applicable for students, retired therapists, professors, and vendors).

As an APPT member, you will receive the following member benefits:

Education and Training: Your APPT membership provides you with access to hours of high quality, low-cost professional seminars and workshops.

Discounted Registration Fees: APPT members can register for our annual conferences, mini-series workshops, and other events at a significant discount. APPT members also may be eligible for discounts offered by other organizations.

Newsletter: A quarterly newsletter promoting upcoming APPT events, industry news, and member accomplishments.

Training Resources: APPT members own a variety of video and audio training programs. Network with your colleagues to borrow these resources.

Professional Support and Networking with Your Peers: Attending APPT meetings provides valuable opportunities to meet with and learn from others in your profession.

Business Referrals: At APPT meetings, you'll meet other private practice therapists who are in the position to refer clients your way.

Reputation Building: APPT actively works with numerous organizations in the public and private sectors to raise awareness of the interpreting and translating profession.

Advocacy for the Profession: APPT representatives work with legislators at all levels of government to help preserve your interests and those of your clients.

Client Confidence in You: Membership in APPT is an indication of your professionalism and commitment to your career.

Leadership Opportunities: APPT offers many opportunities to achieve professional growth via voluntary involvement on our Board of Directors and project committees.

Scholarships: APPT provides opportunities for financial support to attend continuing education programs designed to improve your clinical and practice management skills.

To join APPT, complete and return the application form.

The Psychological Impact of Infertility Treatment and the Mind-Body Connection

2010-06-30T08:17:00.000-05:00

The experience of infertility can often result in anxiety, depression, guilt, and stress. The medical treatments can be physically, emotionally, and socially taxing on your clients. Clinical research has shown that both mind/body programs and couples groups improve a person s ability to cope with their experiences and reduce negative symptoms throughout their treatment. Learn some of these strategies you can use with your clients - - as well as other resources available.

This podcast, recorded in June 2008, can be purchased for $10 (includes 1-hour .mp3 file and 22-page handouts).

Key excerpts:

Infertility affects 7 million people (1 in 8 couples). About 25% has to do with the female; 25% with the male; 35% both, and 10% "we don't know."
The average cost of IVF is $12,000.
The psychological impact of infertility: Many women will experience anxiety and depression levels similar to those experiencing a life-threatening illness, with anxiety increasing throughout the course of the infertility treatment.
Men typically suffer from grief, identity challenges, and interpersonal struggles as a result of infertility treatment.
"Psychological distress" is one of the main reasons cited for discontinuing medical treatment of infertility.
Infertility treatment -- or pregnancy -- may significantly worsen an active psychiatric illness.
Avoid terms that evoke shame and a sense of failure -- i.e., "We are infertile" or "failed cycle" or "unsuccessful fertility treatment."
"Unlike most couples, who are never confronted with infertility, those who encounter infertility are likely to think carefully and deliberately about why they want to be parents, and what children mean to them."
FertileHope is an organization that advocates for cancer patients whose medical treatments present the risk of infertility.

Julie Luzarraga, LCSW, DCSW, has been practicing in the mental health field for over 10 years. She is the founder of The Center for Counseling and Psychotherapy and Emerging Mindfulness. Her primary focuses are supporting people through infertility and working with families participating in Collaborative Divorce.

Julie can be reached at (402) 502-1024 x 290
http://www.midtownmind.com (Omaha, Nebraska)