Training Cliffnotes

Why The Need For This Training?

• Many therapists and practices are moving away from an insurance-based model
• Insurance companies do not reimburse therapists at a good rate
• Getting paid and getting services approved can be complicated
• Private pay practices tend to have better marketing, better customer service, be better overall, of necessity
• Clients have more choice among private-pay practices, so the practice message must be clearer, the marketing better

What type of practice can benefit from these principles:

• All private pay
• Hybrid - some private pay, some insurance-based
• All insurance-based

How Can An Insurance-Based Practice Benefit From Principles Designed Primarily For A Private Pay Practice?

• Clients can often still choose to switch between insurance-based practices
• The principles apply in more phone call settings than just intake calls
• Good customer service skills are universally applicable

Your goal: To help potential clients to make an informed decision that ends with them choosing to work with the best therapist for them and their situation, even if that means paying out of pocket. 

This involves being a compassionate guide, being helpful and sharing good information.

This is not about a hard sales pitch; in the context of therapy, a sales pitch is never appropriate. 

Private Pay Pitch - How To Do It

Benefits - share the benefits/advantages of choosing your practice

• Share any relevant areas of specialization, eg. adolescents, anger management, etc.
• Highlight the practice specialty (eg. working with adolescents) and therapist niche (eg. teenage boys)
• This is more compelling than more generalized services and experience; people want a therapist who specializes in THEIR problem
• Your role is to show them why someone would be a good fit, regardless of ability to pay
• You want the client to ask themselves the question, “Is it worth it that I use my insurance or get who I think is going to be perfect for for my child/me/etc?”
• As the practice owner, look for therapists who have different specialties

Positive reinforcement and affirmation

• Be a kind, helpful, compassionate guide
• HOW you convey information makes a difference
• High touch - lots of empathy, encouragement and warmth
• Some people are naturally better at this than others, but it can be learned. Try to put yourself in their shoes and think, ‘How would I feel in this situation?’ This will help you react to them with more empathy.
• Treat each caller as new and fresh; don’t bring your emotional baggage from other, recent phone calls
• People can hear a smile through the phone line; smile as you talk
• Pay attention to your tone of voice
• After listening, you could say “You’ve called the right place.” / “I’m so glad you called.”
• Use empathetic statements, eg: “That sounds really hard.” “I can’t imagine what that must be like for you.”Help them feel understood (without trying to become a therapist yourself).
• Callers are often on the fence about actually signing up for therapy; encouragement, warmth and compassion can go a long way
• Most of us have had a bad experience with a business’s lack of customer care; people can sense whether you actually care about them.

Fee

• State the fee clearly and confidently
• Do not introduce hesitation, lack of confidence or wiggle room with the fee
• They may have no issue with the fee, but if you sound hesitant or apologetic, you give them room to ask for a discount. 
• Don’t bring your personal view of or issues with money into the conversation
• Never apologize for the fee
• Be confident in the value your practice can bring to the potential client
• Don’t ask if the fee is ‘okay for them’
• Don’t negotiate the fee; example - no one tries to negotiate with their lawyer!
• Say something like, “The fee is $150 per hour - does that work for you?”
• A potential client needs to know clearly what the fee is so they know if they can afford it
• If they go quiet or directly say they can’t afford it, you can say something like:
• “It sounds like that might be a lot of money for you. Therapy is definitely an investment in your wellbeing. I want to make sure this works for your budget, because I want you to be able to continue with the services that are really going to help you. And I don't want you to start with therapy and have to stop before you really get what you need.”

Display your fees clearly on the website

• People want to know what it costs right away 
• Saves you time talking to people who can’t afford the fee
• Allows the client to shop around prices before calling

Convenient location 

• Usually willing to drive 10-20 miles around their house to see a therapist
• Offering tele-therapy eliminates any geographic issues
• The practice location will determine the socioeconomic demographic of your clients
• Share the potential benefits of the practice location with a caller
• Example: In N Out Burger always build their stores near a freeway exit; they’re visible, enticing and conveniently located; location location location

Convenient times

• Have availability when clients want it, eg. mornings, evenings, nights, Saturdays, Sundays
• People are busy - know when your clients are usually busy and arrange appointment availability around that
• Being able to say on website or in follow up calls/voicemails: ‘We are conveniently located here’ and ‘We have night and weekend availability’ is very valuable

Forms of payment - if someone comes into the call planning to use their insurance, convincing them to pay out of pocket must highlight any advantages

• If you don’t already, taking credit cards is a big bonus
• Being able to use a credit card can make a service possible for someone that wouldn’t be if they had to pay cash; don’t assume they’ve thought of using a credit card
• In your script, mention that you take all forms of payment
• Mention if you take HSA (health savings account) cards; many people don’t even consider this as a payment option, but this option may change their mind

One-on-one consult with therapist

• If it’s a complex situation or the potential client can make a better decision after talking to someone with clinical skills
• Don’t do this on a regular basis or as a matter of protocol - only as needed

Offer a superbill

• Make it easier for the client by offering a superbill or invoice for out-of-network reimbursement

Have a Start Here page (or similar) on the website - clearly show what the process of working with your practice looks like

Have excellent follow-through

• Get back to them in a timely manner
• Follow up with them if they don’t respond to calls, emails, etc
• Be super-friendly and super-helpful throughout

Be insurance-‘friendly’

• Offer superbills
• Check their out-of-network benefits for them
• Submit out-of-network claims for them
• If a caller was planning to use their insurance, you could say something like, “We work hard to accommodate people who have insurance that we don't take. So these are the things that we can do for you if you want to work with us.”
• If they really want or need to use their insurance, knowing and recommending another practice in the area that does take their insurance is a really nice touch.
• Doing things like the above goes above and beyond, and makes the client’s life easier, increasing the likelihood they will choose your practice

Share with them the drawbacks of using insurance

• Ask them first if they are interested in this; you could say, “There are some disadvantages to using insurance. Would you like me to share those with you?”
• In order to use health insurance to cover therapy, the client must have a mental health diagnosis first; this may not always be possible, eg. family dynamic issues, relationship conflict, etc.
• Insurance-based therapy is not as confidential; the insurance company has the right to call the therapist and ask how the therapy is progressing
• Insurance companies can control the frequency and focus of sessions
• They often require pre-authorizations, authorizations and ongoing authorizations
• They can at any point say ‘this is no longer medically necessary’, and can cancel the client’s therapy benefits
• Even if the potential client ends up choosing another practice, they will remember how helpful you werewith them
• Example: when deciding what to order at a restaurant, it is just as helpful when a waiter tells you what ISN’T good, as when they tell you what IS good. Be honest in your recommendations.

Don’t bombard the potential client with all this information; ask for their permission to share more information.

If the caller is determined to use their insurance no matter what, you will waste fifteen to twenty minutes otherwise.

If the caller says, “I absolutely have to stay in-network,” you could respond with, “I understand. If you can’t find what you’re looking for, give us a call back. We’d be happy to set up an appointment for you.”

You could also say, “We would really love to help you. But it sounds like this is not actually ideal for you. Maybe this agency across town would be a better service for you.” 

It’s hard to find the right therapist. If you provide good customer service and treat the caller well, they will rememberthat and may come back to you later.

Conclusion

If you as the Intake Coordinator believe in the practice you work for and the therapist you are scheduling for, you will be able to communicate that confidence to a potential client. You won't convince everyone with insurance to pay out of pocket, but you will help more make an educated, informed decision and that will help the world.