If you are limping along, living from one new referral to the next, you might be missing the point of being in Private Practice.  Remember… this is supposed to help decrease the level of stress you had on the job.

Sometimes we lose sight of what brings in those referrals — the foundation we lay, the business we create.  If you’ve gotten away from (or have never had) the basics of what it takes to build a solid “business”, your practice is going to feel like a “job”.

Here’s a reminder of some of the building blocks of a healthy business:

1. Establish business practices (policies & procedures) that are:  in writing, easy to replicate, and are utilized
2. Send a consistent message to the world about who you are, what you stand for, and the services you provide
3. Create a simple, step-by-step marketing plan that is worked even (especially) when your book is full
4. Make good decisions about how your are going to spend your time and how you are going to spend your money; it makes sense to outsource tasks that take up your time, when that time can make you more money doing what you do best
5. Don’t be afraid to spend money on things that have a great return on investment (ROI).  Coaching, a practice management system or vendor, and a larger office with space to rent are investments that will pay off now and forever.  Don’t be penny-wise and dollar-foolish

Seth Godin says that setting up an itinerary of  gigs is a job.  For the entrepreneur, the gig is building the gig.

Are you looking to build a job… or are you looking to build a business?

It takes a certain amount of fierceness to have a successful Private Practice.

Not the kind of fierceness that evokes fear in people; a fierce commitment to success is what you need.

When you tell people that you are going into private practice, you will inevitably get funny looks from naysayers who will give you a laundry list of why they never did it and why you shouldn’t either.

When you have fierce commitment you refuse to be dissuaded, discouraged, distracted or stopped from achieving your goals.  You won’t tolerate anyone or anything interfering in your intentions.

Here are a few things to remember when your fierceness starts to slip…

• Don’t be afraid to claim your niche and proclaim your expertise
• Motivational guru, Zig Ziglar said:  “Timid salesmen have skinny kids”.  Shout it from the rooftops — if you don’t, who will?
• Don’t confuse being busy with being effective
• Beware activity for activity’s sake.  If you’re going to expend the energy, make it worth the effort!
• It isn’t easy; it never will be
• To quote another of my favorite motivational speakers, Jim Rohn:  “It’s no wonder he’s so successful, look at all he does”.  But… just because it isn’t easy, doesn’t mean it isn’t FUN!

I love reading Inc. Magazine.  There are usually at least 2-3 things I can use out of each issue to make my practice a “smarter business”.

A recent article (The Geeks Are Graying) pointed out the fact that 51% of all FaceBook users are over 40;  for You-Tube it’s 49%;  for Twitter it’s 45%.  Wow.

49% of the over 40 folks surveyed said they feel they’re “up to date on the latest technology”.

In school, we learn to “meet ‘em where they’re at”.  I guess that clinical strategy might be generalizable.

If you are  marketing to the over 40 crowd and you want to “meet ‘em where they’re at” — you’d better get online!

What do you think?  What are you doing out there on the web?

Video 2 in the FREE Video Series “Getting Paid”, is “Tips For Setting Fees And Billing” 

Here are a few highlights:

One of the first questions I get from my Private Practice Mentoring students is “How do I know how much to charge?”  It’s a great question.

The answer isn’t as straightforward as some may like, but there are several things to consider when setting your fees (for both private pay and for insurance reimbursement).  Some have to do with your market, and others have to do with your business model.  Here’s an overview…

One of the first steps to take when determining what you will charge for your services is what do others in your market charge for the same services?  Don’t be shy – ask your colleagues.  Do a market survey and find the range that exists with your peers.  Give them a call and let them know that you are updating your fee schedule and would like to know what they charge for X, Y, and Z.  Let them know that you’d be happy to reciprocate when it comes time for them to do the same.

Next, check to see the “usual and customary” rates established by insurance companies in your area (for your market, as reimbursements will likely differ between zip codes/markets).  If you are not doing so already, be sure to distinguish between your Initial Assessment (CPT code 90801) and Follow Ups (CPT code 90806) as the reimbursement rates are usually significantly higher for 90801.

Once you have your data, you can sit down and create a fee schedule.  You can come up with your “posted fees” – the fees you will bill EVERY insurance company.  You’ll want to be sure your posted fees are at least as high as the reimbursement rates of the highest paying insurance company you surveyed.

For example, if the highest reimbursement you found for 90801 in your market is $150 and you are billing $125, that doesn’t make sense.  You don’t want to leave any money on the table.  Insurance companies are only going to reimburse according to your contracted fee schedule.  That means that no matter what you bill, they are only going to pay you what they said they were going to pay you when you signed the contract.  Don’t worry about billing to high – worry about billing too low!

When it comes to private pay, you will have to determine what fee you will settle for (if it will be less than the posted fee you set for insurance).  Some folks do charge more for the initial assessment however; it is more common to have one set fee that applies to both Initial Assessment and Follow Ups.  You may have a higher fee for family sessions or couples counseling.

The private fees you set should be informed by your data, but what you charge will definitely be an expression of your business philosophy.  Some of you will do the market survey and then set your fees low in hopes of attracting more clients.  This is done most often for folks just starting out.  Others of you will do the survey and then set your fees somewhere in the middle.  This is a comfort zone for many therapists.  Still others of you will do your research and then set your fees at (or a bit above) the top.  This takes confidence and a mindset of abundance.

None of these strategies are “wrong”.  In fact, each of them is “right” for the right reasons.

Those who are just starting out and want to charge lower fees justify this strategy with a goal of quickly building a practice.  It involves longer hours to make a living and an ongoing process of raising fees over time, but if this is your compromise for taking the leap of faith – then by all means, do it!

Those who choose the middle ground may find it difficult to ever get away from that comfort zone.  You many always find comfort in knowing that others are being paid less, and frustration in knowing that others are being paid more – BUT… this will be your safe way to run your practice.

The folks who gravitate toward the top of the scale are usually of the mindset: “If my fees are higher, the perceived value of me and my services will be higher”.  There is something to be said for that attitude (and for that reasoning).  Valuing you and your services begins with you.  For some, this starts with the fee schedule.

One thing I try to reinforce at InfluentialTherapist.com is, whatever your modus operandi, be sure you’ve done your homework and you’ve thought through your business philosophy.  Your fee schedule should be a well informed and well thought out expression of who you are as a private practice clinician.

Be sure to register HERE for the FREE Video Series:  “Getting Paid”

DON”T let your concerns and questions about Getting Paid keep you from starting or growing your Private Practice!

Feeling more comfortable with money, payment options and strategies, private pay, insurance, out of network coverage, billing, getting credentialed, etc. can be mind-boggling.  But just like everything else, knowledge is power.

I want you to feel more comfortable about Getting Paid — that’s why I’m releasing my FREE Video Series:  “Getting Paid in Private Practice”.  I believe that you are going to feel a lot better once you start your journey toward self-efficacy when it comes to money issues in your practice.

So, let’s start the journey together.  Watch the videos, and let’s start a discussion about this topic right here and now!

Here’s the link to the first video in the series. Enjoy.