Private Practice Questions: Insurance Request Responses

Common private practice questions: Running a cash-pay therapy practice?

You may often get questions about why your practice is only cash pay and how clients can access their healthcare insurance to pay for a portion or all of their therapy. I often receive these questions as a private practice coach and practice owner. In this blog post, I’ll walk you through exactly how I discuss out-of-network therapy with my clients and give you a step-by-step guide to help you along the way. Whether you are a seasoned therapist or new to the cash-pay model, understanding how to articulate your business model while respecting client needs is crucial.

This is especially important if you’re interested in starting a private practice, building a private practice, or learning how to start a private therapy practice. These foundational elements not only shape your approach to client care but also impact your business decisions regarding salary, expenses, and long-term growth.

Handling Insurance Requests in Therapy

My decision to operate a cash-pay practice isn’t about being against insurance or denying clients access to use their benefits. I fully appreciate the value of insurance coverage for therapy services. Unfortunately, insurance companies don’t provide the reimbursement reflecting the value of therapy, and I am confident in the value I’m providing to my clients.

When setting up your own practice, it’s important to consider the financial realities, such as taxes, liability, and how a non-compete clause might affect your career mobility. Additionally, tracking income and expenses through a dedicated checking account and using credit cards for recurring business charges, like subscription services, can streamline your bookkeeping.

Let me break these issues down.

Clients often ask if I am in-network with their insurance provider. When answering this question, I respond transparently, explaining that I don’t take insurance directly. When discussing payment with clients, I have a scripted response that I find helpful. I say,

 

Now, why do I take this approach? Let me break it down for you. Firstly, I focus on maintaining a therapeutic relationship built on trust and respect. I don’t believe in pressuring clients into paying a higher fee than they are comfortable paying.

Secondly, I have confidence in the value I bring to the table as a therapist. Clients whose needs resonate with my approach and can afford my cash rate recognize the worth of investing in their mental health journey. Clients are often surprised when they learn how physicians, urologists, and doctors in larger medical centers are similarly constrained by insurance limitations, and how that can reduce appointment quality.

Quite often clients come to therapy asking for someone in their network. I’ll help them find a therapist in their network, and sure enough, a few months later, they end up back in my office commenting on how much they appreciated that I was actively trying to help them find the right fit rather than pressuring them.

This level of compassion builds trust and supports long-term client partnerships. Over time, this can reduce staff turnover, minimize burnout, and improve the reputation of your practice. It’s also important to educate clients about their rights under HIPAA and guide them on how their data is protected when using services like Mentaya.

Offering Alternatives: Superbills and Mentaya

Speaking of superbills, sometimes clients ask what they are. My scripted response is, “A superbill is a detailed invoice outlining the services a client received. Therapists may need to generate a superbill when they are not on a client’s insurance company’s panel. The client submits the superbill directly to the insurer, giving the insurer all the information they need to pay the claim.”

Additionally, I’ve partnered with MENTAYA, a service that helps clients submit their superbills for out-of-network benefits. MENTAYA simplifies the reimbursement process, offering clients a hassle-free way to access their insurance benefits while still receiving the quality care they deserve. I often let clients know, “If you need help submitting your superbills I also work with a company called Mentaya that will charge you a 5% fee but do all the work for you. Let me know if you’d like me to send you the information.”
By offering tools like Mentaya and other private practice tools for therapists, you empower clients to take charge of their health while still running a sustainable business. You might also consider building a database of external providers for referrals or legal attorney contacts for reviewing contract terms.

For newer practice owners, tools like billing software, online scheduling, and marketing for therapists platforms can make a significant difference. If you’re not sure where to begin, consult a therapist guide or explore online marketing for therapists to reach a wider audience.

Responding to Insurance Questions with Confidence

Finally, when clients inquire why I don’t accept insurance, I have a response ready. I say, “Thank you so much for asking this important question. Unfortunately, many therapists, including myself, can’t afford to accept the reimbursements insurance companies offer while still providing the quality of care we believe our clients deserve.”

This model also allows for greater flexibility in offering paid parental leave, maternity leave, or even implementing PTO and sick days without navigating the complicated reimbursement models that dominate much of the healthcare industry.
In job settings, these benefits are often discussed during the job interview or interview process and should be considered essential parts of your own practice’s policies.

You may also want to consider offering clear guidance on payment methods, including accepting credit cards or connecting payments to a bank account for auto-pay. Setting a transparent policy protects both the therapist and the patient, while enhancing the overall client experience.

Tying It All Up

Remember, there are strategies for building a successful private practice while maintaining integrity and authenticity. It’s all about fostering trust, communicating value, and staying true to your practice ethos. In essence, there’s no need to convince clients to pay a cash rate. You can help them access their insurance, refer them to therapists who meet their in-network needs, and share your rationale for proceeding as a cash pay practice.
If you’re just getting started, don’t overlook the importance of marketing therapy private practice or seeking out creative marketing ideas for therapists. Your outreach strategy will make a huge difference in attracting ideal clients and sustaining your practice.

I hope you find these insights helpful as you navigate your private practice journey. If you have any questions or want to chat further about this topic, don’t hesitate to reach out. I wish you success and fulfillment in your practice!
To keep learning, explore my marketing guide for therapists, filled with practical advice on business growth, psychotherapy trends, and tools for increasing visibility. Whether you’re looking to improve communication or scale with private equity support, understanding how to position your value is the key to long-term success.

Want more scripts like the one above?

Check out Say It Like a Pro: Essential Scripts for Therapists.