The Human in the Helper: I was going to be resentful and hateful of the field

Alex loves traveling, his husband, and his fur babies. He’s known within his community as a committed mental health leader, dedicated group practice owner, and compelling TEDx speaker. Most importantly, he embodies a genuineness and passionate energy you don’t often see when working within hardened systems that focus on significant trauma and addiction. Seeing how much he’s accomplished in the past few years, it may surprise you to know he was starting to lose his passion and soulful work to the burden of busyness. “It was consuming me,” Alex shared.

Alex describes an imbalance where work was the top priority. He was fielding calls, putting out metaphorical fires, and always having to check his phone for issues, even while on vacation. “I didn’t look forward to coming home [from vacation]. I was stressed at the thought of coming home.” Alex knew something had to shift, but he felt he was committed to his group practice’s growth and goals for the next few years. His spouse described the agency as Alex’s baby, taking his full attention and energy since it was still in an infancy stage of growth.

“That hurt to hear him say,” Alex said, “but it didn’t cause a pivot.” At least, not yet. Alex had been considering a career adjustment for almost two years before he hit his limit. “I was in Oregon on a ropes course and had dislocated my shoulder,” Alex remembers. He recalled how he noticed he was attempting to talk himself into pushing through and finishing, all while in immense pain. “I asked myself, who do I need to prove myself to? Tapping out is okay.” Then Alex felt a flood of emotions as he realized this urge to keep going and pushing through was part of his experience as a group practice owner. He had finally come to a decision, it was time.

Although his community saw the end result as an announcement to close his agency, Alex disclosed several factors that influenced this pivot away from group practice ownership. “I want my husband to be my top priority. I want to do soulful work again. If I didn’t pivot, I was going to be resentful and hateful of the field.” Alex reflected on how his five domains of self—something he presents on often within his community—were suffering under the experience of too much busyness. “Now I’m paying attention to what feels in alignment with my values.”

Alex shared that although he’s grieving the change, it’s a joyful process to see the meaningful differences in his day to day life. “I get to work and do something I love and spend time with my husband.” Alex doesn’t want to live with regrets, especially as he helps his spouse navigate a recent decline in health. “I’m not going to compromise who I am as myself or for my husband for the profession.” In other words, Alex is embracing a shift towards prioritizing relationships and health over work.

A pivot in practice ownership is something Alex wants to normalize for his colleagues. “You don’t owe anyone any explanations. You don’t owe it to anyone but yourself.” Alex went on to describe that pivoting is a normal experience as priorities in life change. How do you know if you need to pivot? Alex has a suggestion. “Imagine you are on your death bed. Will you be happy with how things are now? Or will you have regrets? You can pivot!” Alex doesn’t want to feel like he has ignore warning bells when things are out of alignment, and he doesn’t want other clinicians to respond this way either. “Notice what you are saying to yourself. To tap out is okay.” In support of balance, Alex plans to continue to speak and consult on burnout and soulful work with other helping professionals. It’s a way he can give back to the profession without burning out, which is something he hopes to inspire in colleagues on their own path of self-discovery as well.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

Taking on Private Insurance is Like Learning to Eat Healthy

Taking on private insurance is like learning to eat healthy.

At first you aren’t sure you want to do it. You’ve heard how hard it can be and so you’re on the fence. You enjoy your freedom and don’t want to be tied down by all the rules. It seems like so much effort. It feels too hard.

But there’s this little voice in the back of your mind saying what if? What if eating healthy could be the best thing for you in the long run? So you take the first steps in learning to eat well. You find yourself frustrated with the effort, energy, and resulting mood swings that come from being outside your comfort zone. You continue to question if it is worth all the hassle. You have a couple meltdowns.

Eventually, with persistence, you find your groove. You’re noticing it takes less effort to eat healthy. You’ve found success in having a plan in place, it feels more effortless now. 

The journey of adding insurance to your private practice is a lot like learning to eat healthy. 

The same emotional rollercoaster. The same doubts and frustration. The same growing pains. And in the end, insurance can contribute to the overall health and well-being of your business, allowing it to thrive amidst COVID-19 and beyond.

 So let’s take a look at some of the myths and practical tips to navigating insurance in private practice.

Myth #1: The Panels are Closed

It’s possible that the panels are closed, especially when we understand that insurance data on their providers isn’t very accurate or up to date. It isn’t uncommon to hear that providers listed in directories are retired, deceased, or not taking new clients. So how successful would a member (client) be in finding a qualified provider?  Encourage potential clients to reach out to their private insurance to express their concerns and difficulties. Sometimes this works to open up a panel for credentialing of additional providers in hearing that their members can’t find the services they need.

What can you do as a professional? 

·      Name your Niche: Highlight your specialties and justification for being approved as a provider. If insurance finds you are providing a service their members want, they could agree to move forward with credentialing.

·      Be Persistent: Follow up with closed panels to see if things change over time. Your persistence may pay off if you catch them in the optimal window where they are taking new providers!

Myth #2: Payment is Poor

I recommend to fellow providers that we all find a way to make peace with not being paid what we are worth. Insurance panels will report that they generate their pay structure based on comparable professionals in your area and thus, believe they are offering a competitive rate. Regardless of what they pay, is it still important to you to serve a particular population? Is it worth the effort to help people who need to use their insurance to access services? If you’ve answered yes to these questions, don’t give up on insurance just yet! Panels continue to evaluate rate of pay on an annual basis and I’ve seen the rates of reimbursement improve over time. There’s hope that they will continue to evaluate and increase rates every year.

Professional Pointers

·      Do your Research: What services does each insurance panel reimburse for and at what rate? Interview colleagues to better understand their experiences with certain panels.

·      Renegotiate as Needed: Identify the process for renegotiating your rates once you’ve been credentialed as a provider. It doesn’t mean you will automatically get what you’re asking for but it could spur insurance to take another look at rates for all their providers in hearing from you and others that a rate increase is desired.

 Myth #3: Billing is Unbearable

I agree with you that billing can be a headache. More so when we had to mail in claims or submit them by hand on CMS1500 forms. The good news is that billing has been streamlined, saving time and headaches for providers everywhere! What has streamlined billing over the past ten years? Electronic Health Records (EHR). Popular options like SimplePractice, TherapyPartner, and TherapyNotes have billing processes built in, eliminating the middleman clearing house and auto-filling some billing information based on your calendar appointments to save you both time and effort as a busy clinician.

Professional Pointers

·      Create Templates: Streamline your process even further by creating required templates in your EHR like a credit card form for collecting copays and a Mental Health Assessment to justify a clinical diagnosis required to bill each service.

·      Understand Compliance: Identify compliance requirements based on your insurance contract. Most require a diagnosis resulting from a formal intake, progress notes, and treatment plans for providers to remain compliant and pass an audit.

Myth #4: I’ll End Up Working for Free

There is understandable fear that clinicians could work for free. Insurance panels could take money back if providers make a billing error or if the member isn’t actually covered by an active insurance policy at the time of service. Combine this with confusion about what insurance plan the member/client actually has and the random names for varying plans under bigger names like Aetna and United, it’s no wonder providers feel reluctant to jump on the insurance bandwagon. It’s in your best interest to create a system and process for verifying insurance from the first contact with a client you’d like to work with. It is also in your best interest to bill regularly so you can catch any errors in a timely fashion. After all, it’s even more painful to realize you aren’t getting paid for the last three months in having waited to bill sessions at a later date. 

Professional Pointers

·      Anticipate Delays: Budget your business with anticipation of delays in payment. Most insurances take 2-3 weeks to process claims.

·      Set up EFT: Selecting Electronic File Transfer (EFT) or Direct Deposit of funds will save you some stress in seeing when funds are processed and received in your business account

Insurance doesn’t have to be so stressful. I sincerely and passionately believe that adding insurance clients to your practice will support sustainability and quality client referrals, making your business a healthy one full of growth and long-term potential in offering what you do. 

To learn more about adding insurance to your private practice, check out our webinar, Investing in Insurance: Strategies for Private Practice which features more on the 4 Myths and 20+ Tips of adding insurance to your private practice, making it work well for you!

Pivoting in Practice: How to Embrace Business Change within a Pandemic

We’ve been riding the rollercoaster of this pandemic for months. It’s almost hard to believe. We can’t even begin to fathom the full results of this event and the impact on our businesses. As therapists, we know we must fortify ourselves for the mental health crisis that comes with COVID-19. As a colleague, I’m hearing that we are burning out, stretched too thin by grief, anxiety, and tragic loss. In the grand scheme of things, this means we will need more mental health professionals to carry the load. It also means therapists are maintaining smaller caseloads to allow for self-care in the face of overwhelm. As business owners, we are clenching our muscles and leaning in. As entrepreneurs, we are rallying. Now is the time for pivoting and planning. Months into COVID-19, we are looking for ways to pivot to allow our practices and businesses to not only survive, but thrive.

Planning to Pivot?

Pivoting is a term in business for shifting gears, changing direction, and/or finding new focus. As private practice owners, we get the opportunity to pivot in order to address life’s changes and challenges in ways we feel are a good fit for our business. For some of you, pivoting means:

·      Offering telehealth

·      Providing webinars

·      Speaking online

·      Developing online coursework

·      Writing blogs or a book

·      Identifying a secondary income stream

It can be exciting to start new endeavors, and it can also be challenging. Let’s recognize that creativity can feel limited when other responsibilities require your attention and stress levels are so high that they may hurt your ability to focus. You don’t have to do this all in one shot. You don’t even have to do this alone. Here are some ideas to help you move deeper into a creative mindset to better your business.

Schedule Time for Creativity

That’s right. Put it in your calendar. Where can you find time to work ON your business rather than in it? Can you map out time for brainstorming? Writing? Course creation? Conversations with other inspiring entrepreneurs? I too have learned that if I don’t schedule it, it doesn’t happen!

Move your Body

Have you ever noticed that some of the most brilliant minds are depicted as pacing in movies when trying to figure something out? There is a reason for that! Movement allows deeper processing, especially when it’s a repetitive, low-energy motion like walking or pacing. So get outside and take a walk, allowing your mind to mull over the possibilities at an easy pace.

Remember your ‘Why’

No matter where you decide to take your business, be sure to slow down enough to check in on your ‘why.’ Does this new endeavor support your values and brand? Does it support your mission as a person and as a professional? Carry a notebook and write down ideas as they come to you. Run new ideas by a trusted colleague or friend to see what they think. 

Invigorating Investments

For many entrepreneurs, if the pivot aligns with their business, it can feel both exciting and invigorating to have a direction to go and plan of action to take.  You see, entrepreneurs enjoy building and creating and they feel much more emotionally invested when creating something new or worthwhile. I hope that you too can experience the excitement (dare I say giddiness?) of pivoting in your practice to support your mission, vision and brand. Check out my book Perfectioneur: From Workaholic to Well-Balanced launching June 1st for other ideas on how to thrive as a driven entrepreneur. I can’t wait to see what you create!