[00:00:00]  Linzy: Hello and welcome back to another Feelings and Finances episode of the Money Skills for Therapist podcast. These are our short and sweet Friday episodes where I answer questions from you, the lovely therapists and health practitioners and coaches who make up our wonderful community. Today we have another question from Katie.

[00:00:20]Katie submitted a previous question. This is her second question you’ll hear at the beginning of her question. She asks if it’s okay, and yeah. It’s okay. Two questions is great. So here is our question from Katie for today.

[00:00:30] Katie: I don’t know if I’m allowed to submit two questions, but I am going to and see if that’s okay. My name is Katie Rievert. I am a therapist in private practice in Arkansas.And I’m fairly new to private practice. I started last March. and so I am wondering a couple things about, you know, is it possible to take insurance?

[00:00:56] I’m in the US. Is it possible to take insurance and make enough money to be able to like, do the things you want? I feel like everyone nowadays is moving to private pay, and I think there’s part of me that feels like I don’t want to do all the work of the marketing to do private pay, and to wait to build the caseload, and to also only cater to clients who could afford that.

[00:01:26] So I have some mixed feelings about that, but I also don’t want to work and see 30 to 35 clients a week. So I would love some advice, some ideas about how to hold the amount of work that I want to put in, and also be accessible while also not wanting to overload my schedule. It feels like I have to choose either or, and

[00:01:52] one day I feel one way and the next day I feel the other way. So, yeah, I would love some help finding some clarity and understanding about how to think about that for the future.

[00:02:03] Linzy: This is such a common question, Katie, and is such a necessary question to have to work your way through working in the American system specifically. So my answer is yes. There are certainly ways that you can take insurance, and still have the life that you want, but it absolutely depends on your numbers.

[00:02:26] So the way that I think about this is we each have our own equation. We each have our own equation of how the money can work so that we can both have that amount of sessions each week that, you know, we don’t finish the week feeling like an absolute corpse to put it bluntly, you know, that we’re not working so much that we’re actually sacrificing our own wellbeing and mental health.

[00:02:45] And there’s a different number for everybody. There is an equation where you can work that amount of sessions for, you know, fees that make sense, and make enough money that you are okay. And that is a totally different equation for everybody. So actually in my course Money Skills for Therapists,

[00:03:01] I have a tool that I developed that helps you do this, because the math sometimes is surprising the way that it works. But, there is an equation for everyone. So something I want to reflect to you is I am hearing some black and white thinking here between, you know, taking insurance or not taking insurance.

[00:03:16] And you can actually blend both, right? So once you’re clear on your number, Katie, like if you identify for yourself, for instance, okay, in order for me to be, well, I need to take home.$5,000 a month after taxes, right? Once you identify that number, then you can reverse engineer that into a practice to see, okay, how can I accomplish that?

[00:03:38] If I need to bring home 5,000, there’s going to be some tax money set aside for that. This is how much it costs me to run my business. These are my operating expenses. How much money needs to come into the door to cover all of those things? And then, based on the different insurances that you take, or a fee that you would charge for out of pocket, what is the mix of sessions that would get you there?

[00:03:57] So for instance, like let’s say at the end of that, you know, math that I mentioned, I look at what I need to make and taxes and operating expenses. Let’s say I identify that I need to make $8,000 a month. So $8,000 a month. If I take that and I divide it by, let’s say my insurance reimbursement fee is like one 10, so one 10.

[00:04:22] If I take 8,000, I divide it by 110. I’m just doing this on my phone calculator. I can see that I would need to work 72 sessions a month.So if I take 72 sessions a month, I divide that by four. There’s actually 4.33, weeks in a month, but I’m going to make it a little bit toned down, a little bit more conservative, then I see that that’s 18.

[00:04:40] I would say it’s, it’s even higher because I don’t actually want to work 52 weeks of the year. So then I can work that into the equation, but then I have the opportunity to gut check, right? Like when I look at this, I’m like, okay, 18 sessions a week. If I was fully on insurance, how does that sit with you?

[00:04:53] Is that a number that you’re like, oh yeah, that’s super easy. That would be totally great. Or I’ll tell you, when I look at this number, I’m like, Nope. I cannot do 18 sessions a week. Not all the time, not consistently, right? And so then you have the opportunity to start to play, right? And, and in the tool that I have, we do have the functionality to look at, okay, if you have a blend of like that out OFP pocket and insurance.

[00:05:12] But now we start to see, okay, what does the average fee have to be to get you to the amount of sessions that you want to have? There is an equation there for you, Katie, and being curious about your numbers and sitting down and playing, and just doing a little bit of math, even if it’s just pen to paper, is going to help you start to ground in, okay, to get to where you need to be financially, what needs to come in the door, and how can you get there?

[00:05:32] Is it that you have a practice that is 60% insurance at that 110 fee, but then you also have 40% of your clients out of pocket for 150? Does that get you there? Does it have to be more out of pocket and less insurance? There’s many ways to get there. And something else too, Katie, you know, depending on the reimbursements,

[00:05:53] you can also choose to be out of pocket, but have sliding scale spots, again, based on the numbers that are going to work, that aren’t going to hurt you. Like the accessibility piece is important. Something to remember, though, is like when we’re working for the insurance system, there is profit there, there is money being made, it’s just not being made by you.

[00:06:12] But it is a way for you to connect with folks who have coverage but wouldn’t be able to pay you out of pocket. But you can also think about are there other ways to reach those folks? Can you have a practice that’s mostly in a pocket, but you have four dedicated sliding scale spots that are super clear, super simple.

[00:06:27] People don’t have to navigate insurance at all. You’re able to offer those spots for a hundred bucks an hour for four clients and fully show up for those clients because you’re not exhausted from overworking. We get to do it our way, and you get to do it your way as you’re building your practice.

[00:06:41] Right? And that’s one of the beautiful things about private practice is we have all of that power to do it our way, but we also have the responsibility to think about what we actually want. So that’s where I would suggest you start looking at what you need, looking at what would have to happen in your practice to make that happen.

[00:06:54] And then that will help you start to understand how insurance can fit into this picture.

[00:06:59] So thank you so much for that question, Katie. It is one that I know so, so, so many therapists grapple with,and I appreciate you submitting it for our episode today. If you, like Katie, also have a question that you’d like me to answer on an upcoming episode,

[00:07:13] all you need to do is click on the link in the show notes or head over to my podcast page on our website. You’ll see a little button there where you can just press record. Just introduce yourself, gimme a little bit of context and share your question. I would be really happy to answer it on an upcoming episode of Feelings and Finances. And if you’re also grappling with

[00:07:31] some financial questions, stepping into private practice, like Katie is, and you are interested in getting my help, this is where my course Money Skills for Therapist comes in. This course is all about taking you from money, confusion to shame, and calm and confidence, and helping you build a practice that works for you from the very beginning.

[00:07:46] So we’ll put a link in the show notes for that as well.To get into the course, the first step is to watch my masterclass, the four step framework to getting your private practice finances in order, which will give you a sense of me, what I’m teaching, how I teach it, so you can see if it’s a fit.

[00:08:00] And you’ll then get your invitation for Money Skills for Therapists. So thank you so much, Katie, for your question,and thank you for joining me today.