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The Pro-Insurance vs Cash Pay Private Practice Debate

​I am a firm believer that the only way to really understand what is at the heart of an issue is to ask questions.

Open ended, anonymous, short questions can help you get a real picture of how people are feeling and why.

​That’s why this summer, we created a survey to ask private practice owners to share their perspective on the Pro-Insurance/Cash Pay Debate.

You’ve probably heard both sides of the conversation…

”you won’t make money if you work with insurance companies”

“you’ll never get any clients if you don’t accept insurance”

When it comes to this discussion, most people have some very valid opinions based on the truth of what they are experiencing. Clinicians, our clients and the communities we work in vary so greatly…there just is no ONE answer to how to address the concerns that private practices face. The only thing I know for certain is that if we are committed to meeting the mental health needs in our country, we have to be committed to building practices that are as diverse as the communities we live in.

That dialogue begins with an open minded approach to solving problems. Let’s take a look at what our colleagues had to say.

Generally the comments fell into these four categories.

​Sometimes the broad categorization removes the power of one individual voice. I wanted to include verbatim a few of the responses that I felt really summed up what people are experiencing.

“Clients are likely to attend more sessions and complete goals as money isn’t as much of a barrier.”

“Hurdles with getting credentialed, lack of info about the process (EINs, NPIs, clearinghouses) Too much new terminology to learn (NPI, ERA, EHA, CPT)”

“Smaller client workload to maintain needed income, able to have higher income which allows for more comfort, able to see clients without a diagnosis.”

“If something has to be cut from a client’s budget, therapy is usually the first to go.”

“Never enough clients”

…”I want cash payment AND insurance. Is this possible?”

That last one is probably my favorite.

I so relate with this person’s desire to have the best of both worlds.

Of course I want to help more people, that’s why I came to this field. Of course, I want to make more money, that’s why I am in business. Is there a way to make money AND make a difference? That seems to be the question that all of us are asking.

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