Abundant Practice Podcast – Episode #698: Scared To Go Off Insurance

Host: Allison Puryear
Guest/Caller: (A – therapist in first private practice year)
Date: October 22, 2025

Episode Overview

In this episode, Allison Puryear coaches a therapist navigating the fear of dropping an insurance panel—one that currently covers the majority of her caseload. The conversation dives into the real worries, math, practical steps, mindset shifts, and marketing strategies that come with moving off insurance in private practice. Allison provides empathetic, data-driven reassurance and shares her own journey and best practices from supporting thousands of therapists.

Key Discussion Points & Insights

1. Current Caseload Composition & Initial Fears

[02:04–03:26]

• Guest therapist has a small caseload (15 clients):
  • 9 with the major insurance panel
  • 3 other insurance
  • 3 private-pay clients
• The main fear: significant income loss and client abandonment if dropping off the main insurance panel.
• Allison acknowledges the year is unpredictable but encourages a productive look at the data.

2. Financial Reality Check & The Math

[04:16–06:54]

• Allison guides the therapist through basic revenue math:
  • Insurance reimburses $127/session; private-pay fee is $225/session.
  • If half the insured clients leave, the increased rate may compensate financially.
  • Quote:

    “You’ll be either making more money or not losing much.” (Allison, 05:33)

• Reminders:
  • Not all clients will leave—many value the therapeutic relationship and stay.
  • Be prepared for some to spread out appointments (e.g., switch from weekly to biweekly).

3. Mindset and Framing the Conversation

[07:24–10:25]

• The mindset with which the transition is presented impacts outcomes.
  • Assume clients will stay, not leave.
  • Prepare good referral sources for those who can’t continue.
  • Don’t preemptively reduce fees out of anxiety.
• Quote:

  “If you frame it in your own head, like it’s a mindset…and it is also how you present it to them.” (Allison, 08:18)

• Allison recounts therapists often fear backlash but most clients respond supportively.
• Memorable client reaction story from the guest:

  “She was like, ‘Oh, it sucks we can’t make something work. But I’m so happy to hear you’re full—way to go.’” (12:00)

4. Handling Emotional Reactivity & Projections

[12:04–13:29]

• Many therapists overestimate negative responses, expecting anger or accusations of greed—far more rare than imagined.
• Quote:

  “That’s your own stuff, right? That’s just you projecting…there’s some juicy stuff to work out there.” (Allison, 12:26)

• The guest reflects:

  "I work with some of the sweetest people... I think I'm anticipating backlash that probably doesn't exist." (12:56)

5. Marketing Beyond Insurance Panels

[13:29–15:33]

• The guest seeks advice on marketing and expresses overwhelm/intimidation, especially with social media.
• Allison emphasizes two core strategies:
  • Networking
  • An effective, well-niched website
• Social media is not necessary unless the therapist enjoys it.
• Quote:

  “You never ever have to do social media. … I’ve not done social media for my private practice.” (Allison, 15:14)

• Explore ‘Marketing Fundamentals 1 & 2’ and pick only authentic strategies.

6. Practical Tools for the Transition

[16:02–17:24]

• Rely on data—math provides emotional grounding.
• Calculate how many clients you can lose and still maintain income stability.
• Quote:

  “Doing the math, you figure out what the margins are...there’s relief in it.” (Allison, 16:40)

• Prepare for various scenarios (minimal loss, significant loss, breaking point) and act accordingly.

7. Logistics: Notifying Clients About Leaving Panels

[17:37–19:27]

• The guest suggests a six-month notice; Allison reassures that six to eight weeks is standard and sufficient.
• Quote:

  “Six to eight weeks…that gives them plenty of time…to arrange a handoff or wrap up work.” (Allison, 18:34)

• Resources: Scripts and templates in Abundance Party for those tricky conversations.

8. Allison’s Journey to Abundance Practice

[20:10–22:58]

• Allison shares her story: agency frustration, side practice, leap to private practice in an unfamiliar city.
• Her success led her to “bully” (encourage) friends into private practice; local guidance grew into a national/international support network.
• Quote:

  “I was like, screw this…I’m working so much less, making so much more, and I have spaciousness…no one is breathing down my neck.” (Allison, 21:08)

• Therapists have transferable marketing skills: “The hardest part of marketing for other industries is understanding what their prospects are thinking and feeling. And…we know.”

Notable Quotes & Memorable Moments

• On Mindset:

  “The anticipation of these kinds of changes is so much worse than the actual conversations. 99% of the time.” (Allison, 10:25)

• On Client Relationships:

  “I would not underestimate the impact of your relationship…if someone can, they probably will [stay].” (Allison, 09:30)

• On Proactive Framing:

  “Assume everyone will stay…it really is all about mindset.” (Guest, 10:08)

• On Letting Go of Social Media:

  “You never ever have to do social media. I’ve not done social media for my private practice.” (Allison, 15:14)

• On Preparing for Client Loss:

  “Do the math…figure out what the margins are. There’s relief in it.” (Allison, 16:40)

Key Timestamps for Important Segments

• 02:04 – Caller's fear around dropping an insurance panel
• 04:16 – Allison's financial breakdown: insurance vs. private pay math
• 08:18 – Framing and presenting fee changes to clients
• 10:25 – Emotional projections and actual client responses
• 13:29 – Marketing beyond insurance panels; letting go of social media
• 16:02 – Data-driven approach to risk and client loss
• 17:37 – How much notice to give clients (six to eight weeks)
• 20:22 – Allison’s personal journey into private practice and business building

Episode Tone

Warm, vulnerable, and pragmatic—Allison creates a judgment-free space that blends “feelings talk” with business logic, empowering therapists to act with confidence and compassion during potentially scary transitions. Both host and guest balance emotional transparency with humor and encouragement.

Resources Mentioned

• Abundance Party Membership: Step-by-step guidance for building private practice.
• Marketing Fundamentals Courses: Networking, niching websites, other marketing strategies.
• Templates and Scripts: For client conversations about fees/insurance changes.
• Abundance Party Facebook Group: Community support for therapists making the leap.

TL;DR:
Allison Puryear coaches a therapist through the real, often uncomfortable, financial and emotional process of leaving insurance panels. Instead of fear-based decisions, she advocates for math-driven clarity, authentic marketing, mindset shifts, and leaning into the strength of the therapeutic relationship. The message: most therapists are more ready than they believe, and there’s abundant support available for the journey off insurance.