To Be INN or OON?

*This post is specific to Purposeful Practitioners who have the option to participate (or not participate) as In Network provers with health insurance companies.  

To participate In or Out of Network?  

That is the question most licensed practitioners find themselves asking at least once (or a thousand times) in their career.

There are so many factors to consider in this decision.

Here is what I can share, based on my experience.

First, there are a lot of folks out there selling you the idea that going private pay is quick and easy.  

It’s not necessarily either 🤔

Second, we are “Helpers” and “Nurturers” and so we have to deal with our money shit.  

Why? 

Because we want to help people and people have money shit including not managing it well and, well, just not having it.  

(More on this topic another time…)

Here are my suggestions if you find yourself in that, “I want to cut my ties with Insurance Companies” quandary. 

Let’s actually start with the Pros of participating with at least one insurance company.

People have been trained and trained people are predictable.

We (meaning the collective of licensed professionals) worked really hard to get insurance companies to recognize our areas of expertise outside of just recognizing and including medical doctors for coverage in people’s insurance benefits coverage. 

(Be careful what you ask for 😳)

Humor aside (just for a moment), there are a lot of people who do have access to services now who truly are not in a position to pay for services out of pocket.  

That is not a bad thing.

The challenges, especially for us seasoned and experienced practitioners, is that the Insurance Companies choose not to recognize us as more than a “number" so we don’t usually have much leverage in getting a “raise”.

Doing business with Insurance Companies can be extremely frustrating as it seems as if they get to make all of the rules. 

That’s because they do 🙄

OK, so here are the advantages of at least starting out your private practice days in a relationship with at least one insurance company.

• They do some of your marketing for you
• People have been trained to use their insurance, so they are looking for you
• Having someone’s ass in your office for an hour and getting paid something is more financially lucrative than no one’s ass in your office for that same hour
• You get more Practice which leads to more Experience which leads to more Street cred (your reputation) in the long term

Again, we can dream about how easy our business would be if people would just show up, pay us a shit ton of money to work our magic, and not have to jump though the insurance company hoops and cross our fingers that they are going to pay (and not audit us)….AND….that is just an escape fantasy 😬

Sure, we have all heard the “horror” stories about dealing with insurance companies AND being in business for yourself, whether you participate with insurance or not, is not EASY.  

If you have found a way for money to just show up in your bank account without doing some amount of work for it, let’s go get coffee and chat (SOON). 🧡

I get it, you still want to simply your life and it seems like cutting ties (at least eventually) with insurance companies would be one way to make this dream of simplicity come true.

If you are determined (and I admire you for being determined) then ask yourself a couple of key questions:

• What is your “Why” for going private pay (and I can tell you that “making more money” is not the answer) 🤔
• What encourages people to pay for your services without using their insurance (or being willing to jump through the hoops of OON) 🤔

If you haven’t run screaming from the room yet, let me share my answers to these questions AND how I navigated the process of going from paneled to private pay.

My “Why” for going from participating with three insurance companies to fully private pay did have to do with making more money AND I’m a nurturer so I knew that could not be my sole reason for the change.  I had to dig deeper to find a “Why” that would feed my soul.  The answer I found was that I was ready to “do it differently”. 

Over the years I found that the clients who found me (and responded well to my approach to their Anxiety Related Issues) were not looking for “traditional therapy” AND I found that these were the clients that, when I looked at my calendar and saw them on it, brought a smile to my face.

So the short answer to my deeper “Why” is the ability to “do it differently” 🙌

When other practitioners share that it seems “ludicrous” to be doing notes like “someone is watching me”, I nod my head in agreement AND am grateful that I no longer feel that angst.  

Does that mean that I don’t do my notes in a responsible manner?  Nope, remember that just because you cut ties with Big Brother Insurance Company, you are still a licensed professional (and are required to adhere to the standards of your license) and can still get called into court!

So here is the short version of how I made the transition:

• Originally paneled with three insurance companies, which were a few of the ones I had been paneled with through my agency job
• Participated with them in my private practice for three years before I began the transition - keep in mind that during those two years my practice was full with a waiting list (if you are paneled with insurance and your practice is not full, then we need to have another conversation!
• Chose the insurance company that was the lowest pay and biggest PIA (pain in the ass) to cut first (if you want the details on how that works, that is also another conversation)
• Continued with two insurance companies for another year, at which time one of them was easy to let go as it was just a carve out that the bigger insurance company cut and since I had no clients left with them, they were gone ASAP
• That left me with one, which I kept for another year while I invested time in getting crystal clear on my marketing so as to attract clients who know that I am The One and are willing to pay for my services either fully out of pocket or jump through the hoops of their OON because they know that I am The One who will guide them through the transformation they are ready to make in their lives 🙌

That leads us back to your answer to the second question: "What encourages people to pay for your services without using their insurance (or being willing to jump through the hoops of OON)?”

What can you convey to your Ideal Clients so that they know you are The One for them AND they are willing to choose you OON 😍

When you can answer both questions with confidence, that’s when you start cutting ties 😘

​P.S. - Pop a comment below with your main "Why" for choosing to cut ties with Insurance Companies 🤔