A Quick Guide to Starting Private Practice is now called: 14 Concrete (but not so hard!) Steps to Private Practice: 14 concise steps with tips and resources for Social Workers and Marriage Family Therapists starting a sole practitioner private psychotherapy practice. Plus, six more steps to consider.
This is the Fourth Edition of the Guide – Regularly Priced $29.99 On Sale $19.99!
The Fourth Edition of the Guide is now available. Along with additional resources added since the last edition, it includes a sample introductory letter (marketing!) and seven common forms. Check out the Appendices at the end of the Table of Contents.
Table of Contents
Acknowledgments 1
Introduction 2
Why this Guide? 3
What You Will Find in this Guide 4
A Quick Note Regarding LLC, PLLC, Incorporation, S-Corp, and Group Practice 4
How to Use the Guide 6
First Assignments 6
Staying Organized 6
Success Factors 7
Step One – Consider Your Experience & Regional Area / Name Your Practice 10
Social Workers 15
Everyone 16
Insurance Panels in your Area 19
Assignment: Name Your Business 20
Step Two – Establish Your Tax Id Number (TIN) – SSN vs EIN 22
Assignment: Get Your EIN 22
Step Three – Establish Your Practice Address 23
Ways to Find an Office 24
Things to Think About When Choosing an Office 24
Assignment: Go get your office! 28
Step Four – Email, Phone, Fax, Internet Access, Scanning 30
Read about the Business Associate Agreement (BAA) 30
All-inclusive Services 31
Email 33
Read about email security and HIPAA Compliance 36
Here are four HIPAA Compliant email examples to check out: 36
Assignment: Choose Email & Create your Signature with Disclaimer 38
Phone 39
Read about texting and confidentiality 39
Assignment: Get Your Phone Number 41
Fax 43
Assignment: Get Your Fax Number or at least have a plan 44
Internet Access at a Physical Office 46
Assignment: Decide on Initial Internet Access 47
Read about Camscanner app warning 47
Step Five – Get Your Business License 49
Assignment: Search for your city’s business licensing office. 49
Assignment: Get Your Business License / Pay Licensing Fees & Taxes 49
Step Six – Order Business Cards & Other Signage 50
Assignment: Order Business Cards 50
Step Seven – Join Your Professional Organization 52
Licensed Marriage Family Therapists 52
Social Workers 52
Assignment: To Join or Not to Join, That is the Question 54
Step Eight – Get Insured 55
More about Additional Insured Coverage 56
Assignment: Purchase liability insurance (professional liability, general commercial liability, cyber, and additional insured if needed). 59
Step Nine – Get Your National Provider Identification (NPI) 60
First: Read about the difference between Type 1 and Type 2 NPI 60
NPI National Provider Number – National Plan & Provider Enumeration System 60
Assignment: Get Your NPI & Make Note of Your Taxonomy Code 61
Step Ten – Set Up Your Business Checking Account 62
Assignment: Get Your Business Checking Account 63
Assignment: Make a voided check, scan, and upload it to your computer 63
Step Eleven – Set Your Fees 65
Read – Learn what you are charging for. 65
Read more about CPT codes 65
Everyone: Read to learn more about setting your fees and see session rates 66
Your Fees vs. Your Contracted Rate 66
Everyone 66
HBAI Health and Behavior Assessment Intervention 67
Read to learn about HBAI 67
Read about social workers and HBAI (why we don’t get paid for HBAI) 67
Sliding Scale 67
Read about Sliding Scale 68
Two examples of sliding scale: 69
Assignment: Focus on and develop your fees for the following list 70
Psychotherapy Current Procedural Terminology (CPT) codes 70
Step Twelve – Decide Who Will Do Your Billing (and more…) 72
Collecting Payments 72
For Cash 74
Billing Insurance 74
Deciding Who Will Do Your Insurance Claims Billing 75
Read about Dual Eligible clients (Medicare + Medicaid eligible) 77
If you chose an individual to do your billing 77
Choosing an Agency to Do Your Billing 79
Questions You Should Ask a Billing Agency 79
DIY – Let’s give you an idea of what you are getting into in terms of claims billing. 83
Here’s an Option: Start with a professional biller then transition to DIY later 84
What’s a Clearinghouse, you ask? (finally, we are here) 86
Assignment: Decide Who Will Do Your Billing, Initially 87
Reading Recommendations for growing your billing competency 89
Step Thirteen – Choose Your Charting Method – Electronic Health Record (EHR) vs Paper 91
Paper vs Electronic Health Record 91
Read: why choose an EHR 92
More About EHR with Integrated Billing 95
Assignment: Decide on Initial Charting Method 96
Step Fourteen – Create Your Forms & Celebrate! 98
Assignment: Develop your forms 103
Congratulations! 103
If you’ve completed the 13 prior steps, as soon as your forms are ready, you are set up to see clients! 103
Step Fifteen – To Home Visit or Not to Home Visit 107
Assignment: Decide if You’ll Do Home Visits, Initially 115
Additional Information related to billing and location of session 115
Step Sixteen – Applying to Insurance Panels 120
The Paperwork – Don’t Get Discouraged – Practice Patience – Be Here Now! (again, and repeatedly…) 124
Social Workers: Time to Think about Medicare Again 127
LMFTs – Skip to: 127
If You are an Eligible Provider, Get Enrolled with Medicare First (before commercial insurances and Medicaid) 130
EVERYONE – Apply to State Medicaid/Medi-Cal (Social Workers – take this step after you receive your Medicare PTAN) 134
Medicaid/Medi-Cal Managed Care Programs 134
EVERYONE – Applying to Commercial Insurance Panels 135
A Few Insurance Tidbits Specific to California, Medi-Cal, and/or Medicare 136
Everyone: Back to Determining which Insurance Panels to Apply to 138
Single Case Agreements – side note – a possibility when you are not on the panel 139
Assignment: Apply to Commercial Insurance Panels, enroll as an Accept Assignment Medicare Provider (if eligible), and apply to Medicaid/Medi-Cal 140
Step Seventeen – Get the Word Out – You’re Open for Business! 141
Assignment: Make a list of potential referral sources. 141
Assignment: Write and Send Your Introductory Letter 143
Step Eighteen – Establish Your Professional Will 144
Assignment: Read This & Prepare a Professional Will 144
Step Nineteen – Telemental Health/Teletherapy/Telebehavioral Health, or plain ole’ Telehealth, OH MY 145
Read about how the pandemic has changed mental healthcare 145
California Regulations/Codes for Telehealth 147
Medicare & Telemedicine 147
Terminology: Originating site and Distant site 148
Step Twenty – Compassion Satisfaction, Compassion Fatigue, Burnout 151
Brief Overview of Compassion Fatigue and Burn Out 151
Assignment: ProQoL 151
Assignment: Read Trauma Stewardship by Laura van Dernoot Lipsky with Connie Burk 152
Assignment: Write Out the Nuts and Bolts of Your Self-Care Plan 152
Congratulations! 153
Appendices 154
Appendix A Expenses to Expect – Subletting 155
Appendix B Expenses to Expect – Your Own Office 158
Appendix C Checklist for Success 159
Appendix D User IDs/Names Passwords 161
Appendix E Sample Introductory Letter – use letterhead 162
Appendix F Sample Registration Form 163
Appendix G Sample Diagnostic Evaluation / Biopsychosocial Assessment 164
Appendix H Sample Payment Form for Chart 168
Appendix I Sample Confidential Psychotherapy Notes 169
Appendix J Sample Superbill 170
Appendix K Sample Progress Note 171
About the Author 172
