Abundant Practice Podcast: Episode #596 – Thoughts on Alma

Release Date: November 23, 2024

Host: Allison Puryear

In Episode #596 of the Abundant Practice Podcast, host Allison Puryear delves into the intricacies of transitioning from a group practice to a private practice model, specifically addressing the considerations of partnering with insurance paneling companies like Alma. This episode is particularly insightful for therapists contemplating a shift towards insurance-based practices while aiming to retain the autonomy and profitability of a private practice.

Listener's Question

The episode kicks off with a listener's query:

"I'm planning to transition out of my group practice. I'm considering using one of the companies where you're paneled with insurance through them like Alma. Since the payout seemed to be very good for this area, are there pitfalls I should be aware of? Thank you so much for all that you do."

Allison's Insightful Response

Allison acknowledges the appeal of companies like Alma, highlighting their potential for therapists aiming to incorporate insurance into their practices or those needing to exit agency jobs swiftly. However, she warns of several common pitfalls associated with such transitions.

1. Over-Reliance on Referrals and Complacency

Allison emphasizes that while partnering with insurance paneling companies can lead to a fully booked schedule, it may inadvertently cause therapists to become complacent. Without proactive marketing efforts, therapists might miss out on building a robust private pay client base. As Allison points out:

“They become complacent. They don't learn or implement marketing because they've got that covered with referrals.” ([Time Stamp Unavailable])

This reliance on referrals can be geographically limiting, as insurance companies like Alma may not cover all areas within the United States. Consequently, therapists may find themselves constrained by the regions served by their paneling company.

2. Challenges in Transitioning to Private Pay

Therapists who initially rely on insurance paneling may later realize the desire to shift towards a private pay model. Allison notes that transitioning out can be challenging, especially if the private practice foundation wasn't adequately established from the outset. She advises:

"If you want a private pay practice and you get in with this company, I strongly suggest you concurrently learn how to build the private pay practice that you want and set a marker by which you'll go fully private pay and off these companies." ([Time Stamp Unavailable])

Setting clear milestones, such as limiting referrals from the company and gradually increasing private pay clients, can facilitate a smoother transition.

3. The Risk of Clawbacks

A significant concern Allison raises is the potential for clawbacks. Clawbacks occur when insurance companies audit session notes and determine that certain sessions didn't meet the criteria for reimbursement, leading to financial liabilities for the therapist. Allison explains:

"Clawbacks are when an insurance company audits your notes and decides that you didn't establish medical necessity enough or otherwise document a session that they should pay for. So you end up having to pay them back sometimes thousands of dollars." ([Time Stamp Unavailable])

She cautions that while companies like Alma may claim to protect against clawbacks, therapists should remain vigilant and prepared for such eventualities.

Strategic Recommendations

To mitigate these pitfalls, Allison offers strategic advice for therapists considering insurance paneling:

1. Dual Approach: Simultaneously develop a private pay practice while engaging with an insurance paneling company. This ensures that therapists aren't solely dependent on referrals from the paneling company.

2. Set Clear Goals: Define specific markers or thresholds (e.g., a certain number of private pay clients) that signal when it's time to transition fully to a private pay model.

3. Invest in Marketing: Regardless of the chosen model, proactive marketing is essential. Allison underscores the importance of marketing strategies in attracting the ideal client base and sustaining a thriving practice.

"Marketing is a really good idea for your practice. Whether you take insurance, you take insurance through a company like this, or you're fully private pay, marketing brings in the clients you do your best work with." ([Time Stamp Unavailable])

Resources and Support

Allison highlights valuable resources for therapists navigating these transitions:

• Free Worksheet: Today's episode offers a worksheet titled "Common Marketing Strategies for Therapists." This resource provides a deeper dive into effective marketing techniques tailored for mental health professionals. Listeners can access this worksheet at abundancepracticebuilding.com.

• Abundance Party Membership: For those seeking comprehensive support, Allison promotes the Abundance Party membership program. This program offers step-by-step guidance on building a private practice, covering aspects from marketing to mindset. Members benefit from individual consultations, group calls, and access to a library of courses and trainings designed to accelerate practice growth.

Conclusion

Allison wraps up the episode by reiterating the importance of balancing insurance paneling with proactive private pay strategies. By remaining engaged in marketing efforts and setting clear transition goals, therapists can enjoy the benefits of both models without falling into common traps.

"I hope that helped. If you have questions for Ask Alison or you want to get your hands on the worksheet for this episode, go to abundancepracticebuilding.com." ([00:08])

Through practical advice and actionable strategies, Episode #596 serves as a valuable guide for therapists aiming to navigate the complexities of transitioning to or incorporating insurance paneling in their private practices.

Additional Resources:

• Membership Program: Abundance Party
• Free Resources: Abundance Practice Building
• Support Email: help@abundancepracticebuilding.com

Sponsor Mention:

While the episode primarily focuses on the listener's question and Allison's expert advice, it also includes sponsorship messages from Therapy Notes, endorsing their electronic health record system designed to simplify billing, scheduling, and telehealth services for mental health professionals. Therapists are encouraged to explore Therapy Notes for enhancing their practice management.