Episode #596: Thoughts on Alma

Summary

Abundant Practice Podcast: Episode #596 – Thoughts on Alma

Release Date: November 23, 2024

Host: Allison Puryear

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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.

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Additional Resources:

• Membership Program: Abundance Party
• Free Resources: Abundance Practice Building
• Support Email: [e-mail]

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.

Transcript

[Alison]

Welcome to Ask Alison. Y'all ask the questions about having a fun and thriving practice and I answer them. We have a worksheet for you today so you can bring this answer into your life. You can Access [e-mail] links where you'll also be able to ask any questions you have for Ask Alison. If you want more support, we've got some free trainings in there too. If you can't get enough Ask Alison, check out our YouTube channel for our entire Ask Alison library. Welcome back to Ask Alison. Here's today's question. 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. So first I want to thank Therapy Notes for sponsoring Ask Allison. They are the number one rated electronic health record system available today with live telephone support seven days a week. Clear why? TherapyNotes is rated 4.9 out of 5 stars on Trustpilot and has a 5 star rating on Google. TherapyNotes makes billing, scheduling, note taking and telehealth incredibly easy. And for all you prescribers out there, they also offer e prescribe if you're coming from another EHR. TherapyNotes is making this transition super easy for people. They import your demographic data free of charge so that you can get going right away. Find out what more than a hundred thousand mental health professionals already know. Use promo code [e-mail] for two free months. You really wish grad school had covered how to fill a private practice. In grad school you had a professor you could ask questions. Someone who could tell you what you were doing wrong and how to fix it. You had classmates working towards the same goal. Think of Party plus like that grad school class you wish you had. You get individual consultation about your specific practice with clear feedback and guidance. You get group calls with other people building their practices who have your back. We cover everything from marketing to mindset and you have access to everything in the Abundance party all the courses and trainings that have filled thousands of therapists practices. Thanks to the feedback, the support and the clear step by step, people in party get full faster. The majority of party members fill their practice in three months. Check out Party in the link in the show notes and join the interest list if you're ready to build what you've been dreaming of. All right, so let's get into it. These companies can be a really good option for people that want to take insurance in their practices. They can also be a good option for people who eventually want to be private pay, but circumstances require that they leave an agency job quickly. I haven't ever worked with these companies personally, but I will see the pitfall that I see over and over again with the people that I'm working with is that they get in with these companies, they end up full at some point. Sounds good, right? But then they realized they didn't build the private practice that they meant to build is this is especially if they wanted to be private pay. They become complacent. They don't learn or implement marketing because they've got that covered with referrals. And this isn't everywhere in the United States. They don't get full everywhere with these companies. But the people that do end up coming to me later because they realize they don't want to be reliant on these companies for their income. They then, while maintaining this full practice, have to learn and implement marketing to build their private pay practice and extract themselves from the company. Another pitfall I've seen, and I can't remember whether it was ALMA or another one, is that they say that they protect against clawbacks, but they haven't. Now callbacks 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. And this can happen to you if you take insurance in your own practice. But there you didn't have this guise of safety where a company said we'll take care of callbacks for you. 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. So maybe you limit the number of referrals from the company and when you have 10 weekly private pay clients, you stop working with the company, that kind of thing. And I made up the number 10. You need to do the math for your life and your practice just to see what cut off makes sense. Marketing is a really good idea for your practice. Whether you take insurance, you take insurance through a company like this, or your fully private pay marketing brings in the clients you do your best work with. Today's free worksheet is common marketing strategies for therapists. We go deeper and teach you how to do each of these step by step in the event Dance party if that's something you would like some help with. If you have any questions for Ask Alison, send them our way. I would love to answer them. If you're ready for a much easier practice, Therapy Notes is the way to go. Go to therapynotes.com and use the promo code abundant for two months free. 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. If you're listening, you probably need some support building your practice. If you're a super newbie, grab our free checklist using the link in the Show Notes. I'd love for you to follow rate and review, but I really want you to share this episode with a therapist friend. Let's help all our colleagues build what they want.