25. Pros and Cons of Insurance vs. Private Pay Practice

Taylor (00:00)
Hello everyone, welcome back to the Social Work 12th podcast. I'm here with my co-host Faith and today we're chatting about insurance versus private pay for your private practice. I feel like that is just a really big decision that social workers have to make. Am I gonna take insurance? Am I not? How does all this work also? So yeah, we're gonna get into the details. So excited for.
Faith to be here for this one because obviously she has real world experience with her prior practice.
Faith (00:32)
Yeah, dude, this is going to be good. It's something that we don't always talk about. So I'm excited that we're going to talk about it today. And it can be a bit controversial in the field. So it's nice to kind of give space to it and talk about the different opinions as much as I don't know, as much as I know about them or as much as we can pull up. So yeah, yeah.
Taylor (00:43)
Mm-hmm.
Right. Yeah.
So I guess let's just start with like when you were starting your private practice. I mean, you are working at a group practice, but like what was your first thought about, you know, gut reaction insurance, first private pay? Like how were you thinking about it?
Faith (00:59)
Yeah.
Mm-hmm. Mm-hmm.
Yeah, so when I first started private work, I was abroad, right? So I was in Switzerland, and it was a no-brainer that I would do private pay because I couldn't do insurance because I lived abroad. So I wasn't able to do, like, their insurance. ⁓
Taylor (01:20)
Right.
Faith (01:28)
Yeah, I wouldn't have the credentials to do that there. So when I got back to the United States, I was like, sweet, now I can do insurance. Like, I'm legitimate. I can do this. This is going to be great. And I think it made me feel initially really secure. OK, I'm going to have a ⁓ I guess, like referral source. My caseload probably will fill up pretty quickly. And I'm not going to have to like worry as much about.
can my clients afford this? It just was like a steady stream. So I was actually looking forward to it and saw it as a relief and like job security kind of, think, ⁓ in the beginning for sure. Yeah, I think I was like, this is great. Now can actually provide affordable care and have a good decent income. Yeah.
Taylor (02:17)
Mm-hmm. When you were,
I mean, when you came back from being abroad, you were at the group practice. Did you guys take insurance there?
Faith (02:23)
Yeah, so they did take insurance there. ⁓ But I didn't see all of that, right? Obviously, because you're in a group practice. So there was like a split happening there. But ⁓ yeah, we took insurance there. think everybody took insurance. And I think there were moments where some people were trying to do all private pay.
Taylor (02:29)
Yeah.
Faith (02:43)
Everybody would talk about like they're not full. They can't fill their caseload like it's really hard to fill your caseload and so there was a little bit of this feeling of intimidation to for me at least or like ooh You're gonna have to just give it time and space for your caseload to fill up if you want to go private pay And so you have to have like the financial flexibility to do that, right? I would think
Taylor (03:05)
You mean
when you're transitioning from a previous employer? Is that what you mean? to then?
Faith (03:12)
Yeah, mean, you're
transitioning from employers and you want to go all private pay and the employer is okay with that, then like if you're in a group practice and you say, would like to do private pay, like your employer also would have to be okay with that. Because if they're taking a split, they want also consistent income probably as well. So yeah, you probably have to have...
Taylor (03:32)
Mm-hmm.
Faith (03:38)
the financial stability or safety net for yourself to go without pay for a little while while you're building up your private pay practice. And sometimes that can take like six months. I've heard from some people, but that's not always the case. But I think that there's just like that fear of like, ugh, can I?
Yeah, and like would I be able to afford my life while also trying to my caseload and all of that with private pay? At least that's what I was feeling for sure. Mm-hmm, yeah.
Taylor (04:09)
Yeah, yeah. That also makes me
think about just kind of the reading that I've done for, well, I was gonna maybe start a private practice. And then I was like, actually, I don't wanna do this. ⁓ Did you know that? Did I tell you that? yeah, yeah, But one thing that I...
Faith (04:19)
Okay. Yeah, you did tell me that. Yeah, you did tell me that. Yeah. Yeah. Why did you decide not to?
Taylor (04:35)
Gosh, I was in a transition from my current job, not in transition, but just starting to feel like, I don't know, is this sustainable? You we were gonna be moving and I couldn't do the job that I do now remotely. ⁓ I mean, fast forward to now, I'm just like a travel social worker, but part of me was thinking maybe I could do remote work and just have like a complete virtual.
Faith (04:49)
Mm-hmm. Yeah.
Yeah.
Taylor (05:03)
you know, practice. And I remember reading about, you know, going private pay, it really could benefit you to really niche down. ⁓ And obviously, you know, there's still going to be time, there's still going to take you time to grow your caseload. But it seemed like if you were going to be private pay, like really niching down and getting specific about the population that you want to work with.
Faith (05:03)
That's cool.
Taylor (05:32)
is important. ⁓ And then so I was I was considering kind of honing in on grief and loss and supporting people through that. But ultimately, I was just like this. don't really want to do this. I don't actually want to start another business because I already have this business like social work to wealth is my side thing and.
Faith (05:43)
yeah.
Taylor (06:00)
I wasn't gonna have the private practice on top of, you know, like working, doing.
Faith (06:03)
and then also
your day job and then you're going to school. Taylor does way too much.
Taylor (06:07)
Yeah, and like I was gonna leave it. was gonna leave it.
It is true.
But yeah, I just like, I feel like this is I'm forcing it and I if I'm going to. It would just be a whole new business kind of that I would need to learn, and I was just like, I don't really want to do that and want to save energy for social work, wealth and also pursuing personal finance. So. Yeah, I think I think it's important to.
Faith (06:18)
Yeah.
Yeah.
Yeah. Yeah.
Makes sense.
That makes sense.
Taylor (06:41)
kind of consider season of life, the capacity that you have and also, yeah, the financial like savings. what have you heard in terms of like niching down? Cause I think some people are concerned about like, well, I'm not going to get clients or, know, just, I think I feel like people think casting a wider net will help them bring in more people.
Faith (06:45)
Mm-hmm.
Yeah.
Mmm.
Yeah, so I don't think that that actually is effective. I think niching down is the way that you can run a successful private practice ⁓ because then you become known in the community as the person that does that specific thing as opposed to everything. And so then people are willing to maybe pay privately for that because you're specialized. ⁓ Where if you just treat everything, well, why
Taylor (07:15)
Yeah.
Yes.
Faith (07:40)
I just go then to somebody else who...
treats, takes my insurance and treats everything like there's no real incentive. And also when you niche down, you do like you become more specialized. You become really good at what you do and you become known for that and your clients feel that not to say that people who take insurance aren't really good. They are. It's just you're getting more and more specialized. You're treating the same type of condition potentially in more than half of your caseload. And so you're just going to get more.
Taylor (07:46)
Yeah, that's a good point.
Faith (08:13)
familiar with that or understand that more, do more trainings in it and really you're really marketable I think when you niche down. People know what you do and so then when they're like I have this client who has this type of condition ⁓ your name comes to mind.
Taylor (08:21)
Mm-hmm. Yeah.
Yeah, totally.
Or when you're going to network with people like, yeah, this is what I specialize in. if you're going to doctor's offices or just networking with other therapists, I think it's helpful for people to, yeah, have like, ⁓ when I think of Faith, Faith is OCD and PTSD. Like if I have a client, I would refer them to her.
Faith (08:36)
Yeah.
Yeah.
Right. And also just like pediatric OCD, like even specializing down to the population, not just the condition and then also the modality like pediatric OCD and I do ERP, right? So like really getting specific about what you do. ⁓ I think it's really, really helpful. I think ⁓ the other thing is
I would recommend when you are, if you want to do a private pay. I'm speaking, I don't do private pay. I'm like talking like I'm doing private pay right now. I don't, and we can talk about why that is maybe in a minute. I'm doing both, doing both. It's hybrid, it's a hybrid model, but, so we'll talk about that a little later. But I think one other.
Taylor (09:31)
I mean, you're doing both. You're doing it's hybrid. Yes.
Faith (09:41)
piece of advice is to not network with people who do what you do. So like, I wouldn't necessarily network with other OCD therapists only if I was like, I need more referral. I need to know if my caseload's full, who I could refer an OCD client to. Then obviously I would...
network for that reason. But if you're looking for like referral streams, you want to network with people who don't do what you do, who are going to run into that condition and be like, I don't know what I'm doing here, and then refer out. So I think sometimes we can be like, oh, you do what I do, let's network. And it's like, actually network with people who don't do what you do. Maybe that's a simple piece of advice, but yeah. Yeah.
Taylor (10:23)
Yeah, yeah, that's a good point. Yeah, yeah, totally.
Yeah, let's talk about private pay versus insurance pros cons. So I have here private pay pros, more control of your rates, less paperwork, client privacy, because there's no diagnosis required, the insurance is not looking at their notes, potentially fewer clients.
Faith (10:34)
Yeah.
Hmm.
Taylor (10:50)
depending
on insurance reimbursements versus what you're charging, which could allow you to have more energy and just like, yeah, maybe work less days. Cons for private pay, requires more marketing, niche clarity like we talked about. Can it feel emotionally harder to say your rate out loud? Like, I charge $155, you know?
Faith (10:56)
Yeah.
Yeah. Yeah.
Mm-hmm.
Mm-hmm. right.
Taylor (11:18)
Any
of those hit home for you from your experience.
Faith (11:23)
Yeah,
definitely. ⁓ I think also another con would be it's going to take longer to fill your caseload potentially and...
There's two reasons for that. Like it's going to be harder to find people who have the financial flexibility to pay privately. That's just going to take time. And then also you might not have people seeing you weekly. might have people seeing you every other week. And so if I'm trying to fill 20 slots with weekly clients, then I only need 20 clients. But if I'm doing private pay, I'm probably going to have 40 clients on my caseload because you're going to do every other week with people for financial burden, you know, that, that, that private
pay causes. that's also why takes longer is you just have to have, you know, you're probably going to rotate people every other week as opposed to weekly. So that's just something to keep in mind. ⁓ That's another con. But if you have the flexibility, you have the support system, you feel like you can do it, then in the long term, ⁓ it's nice because you don't have to worry about all the paperwork. You don't have to worry about like,
Taylor (12:28)
Yeah.
Insurance clawbacks.
Faith (12:34)
insurance clawbacks
and you can have a little bit of flexibility in terms of how many clients you see especially if your rate is a little bit higher and yeah so also sometimes this is not always true and again like
throwing out a ton of disclaimers here, like, don't come at me people. But also sometimes people are more committed to the process because they're investing ⁓ their money in a different way. And so they're more invested in the therapy process and you sometimes can get better outcomes. So there's that as well that sometimes can happen.
Taylor (12:57)
Hehehehehe
their money.
Faith (13:19)
too. So in my experience, private pay was super easy abroad just because of the environment I was in. It was super normalized. Everybody did it. It was expected. Here, I've felt more feelings about doing private pay and more intimidation to do private pay ⁓ just because it's not as ⁓ normalized. And it is seen as something like, I think, more
rare in like not everybody's doing it as much and there's more like kind of opinions about it or you know that kind of stuff like yeah yeah yeah
Taylor (13:53)
Mm hmm. Yeah, let's talk about the opinions about that. ⁓ Yeah, I was like,
we were going to talk about this later, but I feel like it's a good time because because one of the cons I have down is feeling like you're not quote unquote accessible, ⁓ you know, kind of like the shame narrative. But yeah, I. ⁓
It was perfect timing for this episode. Yesterday I saw this reel where the social worker was saying that she saw another reel inception ⁓ that a social worker was the social worker was saying you are not an anti oppressive therapist if you're only private pay. Like if you don't take insurance ⁓ and that is just.
Faith (14:43)
Hmm.
Wait, say that one more time.
Taylor (14:49)
She said, you're not, this, well, this video I was watching, she was talking about another reel, but that social worker was saying, you're not an anti-oppressive therapist if you don't take insurance.
Faith (14:56)
Right?
You're not an
anti-oppressive therapist if you don't take insurance. ⁓
Taylor (15:05)
Don't take insurance. Like if you're only pay private pay, you're not
an anti oppressive therapist. And this person who I was watching last night was saying like, first, this energy is kind of like misdirected. Like the real problem is the healthcare industry and like this capitalistic society that we live in. ⁓
Faith (15:20)
I was gonna say, which is
oppressive.
Taylor (15:25)
Which is oppressive, yeah. So we're also
in this oppressive system trying to do what we can. One, why are we shaming other social workers trying to just like do the best that they can? That, we're not here for that. We're not here for that. And then she was saying, there's other ways to be an anti-oppressive therapist. Decolonizing your practice, protecting your client's identity, the way that you write notes, making your services accessible, like.
Faith (15:31)
system.
I don't ⁓
Taylor (15:54)
One way to be more quote unquote accessible without insurance is to maybe have a sliding scale fee. Like there are other ways that you can kind of support your community. And one other thing, I'm gonna bring up the video. Someone has said.
Faith (16:04)
Mm-hmm. Mm-hmm. Yeah.
your clients.
Taylor (16:18)
Like I submitted my credentialing to Medicaid two years ago. They still haven't paneled me. Of course, I've advocated for myself with the states. It takes a long time. this these comments also don't take into account how challenging it could be to even get on a freaking insurance panel, let alone a federal insurance. Like, what? What are we doing?
Faith (16:40)
Yeah.
Yeah, I think, yeah, let's talk about insurance too. Like, I think that there's a lot of cons to doing insurance. And...
therapists have to do like this gymnastics to like not share too much information in notes, but share enough where you don't get clawbacks and No one really talks about or knows how to do that perfectly. And so you're always kind of sitting with this horrible feeling of anxiety of like when am I gonna get audited? When am I gonna get my notes pulled? When am I gonna get?
Taylor (17:12)
Stress. ⁓
Faith (17:19)
is this gonna piss off my client because I had to put something in the note in order for them to get insurance reimbursement that I didn't really want to have to put in the note, but if I don't, then they're not gonna get it. And like, it feels really, really...
Taylor (17:28)
Right.
Faith (17:35)
scary at times because we're not our reimbursement rates aren't like amazing either and so you're not like rolling in it to be able to cover like a clawback and if for those of you don't know what a clawback is that's where insurance contacts you maybe a year or two even after you've met with that client and says hey we don't think that the services you provided on this date were actually necessary and so we want the money back that we paid you.
So if you don't have that money saved to give back to insurance or have a way of kind of contesting that or kind of fighting that. ⁓
Taylor (18:08)
Yeah.
Faith (18:09)
you're kind of out of luck and most therapists don't feel comfortable going to their client and saying, hey, two years after the fact, you have to pay me because your insurance actually didn't cover that one session or five sessions or whatever. ⁓ Most therapists are just going to eat that cost and give it to the insurance. And so like if we want to talk about our oppressive system, what is that? What is, what is that? And so
Taylor (18:33)
Yeah, yeah, yeah, yeah, a health insurance company determining
what's appropriate care when we are also like masters level clinicians.
Faith (18:40)
Yeah, and some of these health systems,
yeah, right. And some of these from, I mean, from the limited knowledge I have, some of these ⁓ health insurance systems are now being run by like AI, like some of these auditing systems, like it's kind of like automatically run through to find like red flags. And so it's not even necessarily like,
I mean, I don't think it's like somebody going through and auditing every single claim. It's like they have an AI system that does it. And then you kind of get this automatic audit email. So you have to, you should always contest it. You should never just like give the money. You should always contest it. But ⁓ I think that is.
a really intimidating process for therapists. And that's another reason why therapists don't want to take insurance because it's a lot of extra work. And then also the confidentiality for your client becomes tricky at times ⁓ with insurance. yeah, in terms of like they can read all the progress notes and everything. So.
And they're not supposed to use that against ⁓ clients. Like they're not supposed to use that against clients. Yeah, like to deny care or anything like that. Like there's been laws passed against that. But I think there's still always this feeling like that could happen. And I'm sure there's cases where that still happens. ⁓ So, yeah.
Taylor (20:04)
Like what's in the notes?
Yeah, yeah.
And we also, saw that there, we saw this article, what's her name? Sharla Yearwood. ⁓ She wrote an article, Private Pay Therapy and Social Justice Can Coexist. I'll put it in the show notes. Yeah, and.
I just love she said, you know, with the insurance, like your business becomes dependent on companies that have little regard for you as a clinician, your clients and the care that they're providing. And kind of the beginning context of the article was she used to think that if you, you know, didn't take insurance, then you weren't, you know, down and you weren't the social worker that wasn't like in it for for social change. But over time, she's learned
that
like she can charge rate that allows her to mean like a sustainable caseload and she's not forced to overload her schedule. ⁓ She has time for time for professional development and so it's it that's interesting.
Faith (21:21)
Yeah.
think like this idea that somehow you're not a social worker because you don't take insurance, come on. That is just so unnecessary.
Taylor (21:30)
It's the martyr. It's the martyr. It's the martyr
again and again, because we for some reason just have to like be the saviors and like make it so easy for everyone to have access to everything. And we try our best. That's why we like got into this work and went to school. But my gosh.
Faith (21:41)
He is saviors.
It's so, it's
so shaming and it's actually not asking the right question or investigating the right question. It's not, it's just judging people for these decisions instead of saying, well, why is it that therapists are leaving insurance panels? How about we get curious about that? ⁓ and there's like gonna be, cause I think in some...
Taylor (22:06)
Yeah.
Faith (22:12)
statistics I've seen, like 30 % of therapists don't take insurance. That's a large amount of therapists that don't take insurance. Why is that? It's not because they're all like, I don't care about people and I want to reduce access to mental health care and I'm just trying to get mine. Like that's not what's happening. And so these are people who care about their clients who are trying to do good work.
Taylor (22:16)
Wow.
Totally... right.
Faith (22:35)
but they're sick of probably sitting with that anxiety all the time and they're over it or they had an experience where they're audited and they're like, I'm done or they're, you know, and they're choosing not to engage in a system that they see as broken.
Taylor (22:43)
Yeah.
Mm-hmm.
Yeah. Let's see. So moving on to kind of like specifically insurance, those are some cons, obviously. Some reimbursement rates are low, ⁓ risk of delayed payments. ⁓
Faith (22:54)
Yeah.
Yeah.
Yep, yep,
you can be waiting three months to get a claim paid.
Taylor (23:08)
paid out. Like,
That's something you have to build into your like financial picture. You know, if you're if you know, OK, I'm submitting this claim today and I'm not going to see the money until December or January. That is that's that's really challenging, you know, versus someone just paying with their card and you getting the money right away. So definitely I feel like there would need there's need to be a little bit. I guess I'm curious how you do that. Is that the payments?
Faith (23:18)
Yeah.
Taylor (23:41)
that you get, what are they through Alma? Yeah.
Faith (23:41)
Yeah. So I do Alma. So for anyone
who's interested in that, there's like, think, Taylor, on your website, have like a referral code, but also like a whole private practice ⁓ blog post that you did. And in there is a referral code and some other suggestions and stuff. But I do Alma. And the reason why I like Alma is because ⁓
they essentially guarantee that you're going to be paid within two weeks of the claim being submitted. So they kind of wait for the claim to be fulfilled by the insurance company and they pay you immediately, the therapist. And that was what attracted me to that because I was like, I don't want to wait three months for a claim. And then it's like, wait, what? Like that just gets really messy. Like how do you keep track of all these claims coming in? And so I really liked all of them for the way that
They tracked the claims, they paid it out right away to me, and I could just make things a lot simpler. And then ⁓ also, they credential you with insurance, and they're the ones negotiating the rate, too. So yeah, I think it just made it a lot easier for me in that sense. And when I was going out on my own, ⁓ I'd...
didn't want to have too much of a lapse in my income. So I knew insurance was like kind of like a safe bet when it came to filling my caseload. So, so yeah.
Taylor (25:05)
Mm-hmm.
Yeah, yeah, and that's the pro. That's some of the one of the pros
for insurance built in referrals. So less marketing needed. Can fill your caseload faster. Could feel like kind of like a safer start when you're like transitioning into ⁓ doing private practice. Do you feel like you get a good amount of like how does the referrals work through insurance? Are they through Alma? Are people finding you other ways?
Faith (25:19)
Yeah. Yeah.
Yeah.
Yeah,
so for insurance, ⁓ I'm with only two insurance companies and they're both through Alma, the insurance ⁓ that I'm credentialed with, and they ⁓ have like a referral tab, essentially. You just like click on like, I'm accepting consultations right now, or new clients, and then.
Alma sends them to me through like their referral service and I believe Like they work with insurance to like help connect patients to therapists and so I get like a little alert saying like hey somebody's interested in working with you and they like and then I can follow up on that ⁓ and it works really well like I just got back from maternity leave and I had probably within a month like
10 to 12 referrals in there in the Alma portal and then I probably got like six from other sources like Psychology Today, other therapists and since I do OCD work I got a couple from Rogers Behavioral Health Hospital that I partner with as well. like try to like diversify where the referrals are coming in from but
Alma's a good source of it, for me at least. It's worked out. Yeah, I know some therapists have told me they have gotten very little referrals from Alma. And I wonder if that's because of the insurance they're paneled with, because I'm paneled with Aetna and United and a lot of people have United. And so I think that's why I get contacted quite a bit for therapy. Yeah.
Taylor (26:59)
Mm-hmm. Yeah.
Interesting. Yeah. And
I wonder, do you remember that like Alma, did they advertise to you? Like, we'll give you referrals or, we'll, help you with referrals. Cause I think I saw there's, there's some of these companies that help you with kind of like the credentialing and maybe you their EHR and people complain that like they don't get referrals through them. But it's like, is that the purpose of that service to get you referrals or is the purpose of the service to
get you credentialed with the insurance and kind of like manage the paperwork and in the communication with the insurance and the EHR the you know electronic health record system for charting ⁓ you know what I mean
Faith (28:04)
Right. Yeah.
For me, you know, I don't know what all my selling points are. Like, I'm not sure if they're like, this is our main thing. It seems to me that the main thing that they're really working hard on is like credentialing therapists with insurance.
Taylor (28:13)
Mm-hmm.
Faith (28:27)
and helping them with the whole billing process, submitting claims, getting quicker pay. Their EHR is not really robust yet. ⁓ I use Simple Practice as my EHR, and I use Alma as my biller. All the credit card transactions happen through Alma ⁓ for co-pays.
Taylor (28:33)
Yeah.
Yeah, I'm on their site right now.
It says like, you know, simple 45 day credentialing process, ⁓ automated client eligibility checks. That's kind of nice. Multi-state credentialing.
Faith (29:00)
yeah, that's right. do,
they do credibility checks every month for your clients because the amount of times insurance expires or something changes and they're no longer eligible. So that I liked too, that they do that, you know.
Taylor (29:09)
Totally, that's, oof. Negotiating reimbursement
rates for you. I guess they have continuing education. But yeah, I mean, like, I don't see anywhere on here where they're talking about, like, helping you, like, with clients and getting referrals. ⁓
Faith (29:19)
they do.
referrals.
great.
Taylor (29:31)
Yeah,
but you're still probably you're listed on. mean, you're listed through Alma, but then I'm sure if I had United Health Care, I could go on to see what therapist takes my insurance and you would be listed on like there. The insurance provider portal also, right? Yeah. OK.
Faith (29:44)
They're correct. Yeah, yeah, right. Yeah,
I would be in. I'd be listed on there. I'd be listed on Psychology Today on my website. I have other therapists that I've worked with. I really do get out there and network with people in my area about like what I do and what I provide. I'm a part of like a therapy collective, which is where we all share an office space together. So like I am connected with people too. So like if you're wanting
Yeah, if you're, that's a whole other topic, private practice building. Yeah. Yeah.
Taylor (30:18)
Private practice building and like private practice marketing. Yeah, I think.
I think we can touch on a little bit just the fact that like, I think sometimes people think like, okay, I'm getting insurance. I'm just going to like get all these referrals through psychology today and just the insurance portal. And maybe that can work, but there's also like some other kind of marketing and networking that you will need to do. Like maybe you're going to doctor's offices. Maybe you're going to talk to lawyers. Maybe you're talking to financial planners in your area because
Faith (30:28)
Yeah.
Hmm.
Taylor (30:52)
someone who's in the financial planning space some people might need therapy you know like yeah
Faith (30:55)
Yes. Yeah. Yeah.
Yeah, you have to do that work too. You do. Yeah, I think that that's realistic as well. It's like putting yourself out there, making those connections, reaching out to people. And that's why, yeah, I don't want to get on a tangent, but I do feel like that's why it's so important to...
stay connected with other therapists and other groups, especially if you're going to be an online therapist. Like you really need to put yourself out there to be successful, I think, and not be afraid to reach out and make connections and go out for coffee with people and, you know, cause also therapists. ⁓
they really want to do best for their client and they're not just going to refer to you if they haven't. Some people won't refer unless they've met you. like you, they, you know, they want to know like, who am I referring to? You know, are you just like, yeah. So especially if they're going to say this is somebody I trust and I think they're to do really good work. So I get a lot of referrals from other therapists. I get a lot of referrals from Alma and I get a few from psychology today. It's not great. It's not a great referral source. get probably, yeah, yeah, that's probably the least
amount that I get from Psychology Today. So yeah, my Gay Psychology Today profile is not gonna cut it, I don't think. Maybe I'm wrong, maybe there's other people who like, I get all my referrals from there. I don't know. For me, it's been not, I mean, like a couple a month, maybe. Yeah. So, so yeah, there's a lot of pros to insurance. There's some cons to insurance. There's pros to private pay. You know, there's cons to private pay.
But yeah, I don't know what I'm saying and all that, but I don't really have a summary. That's what it is.
Taylor (32:46)
It's I think ultimately, ultimately, it's like
there isn't a right way to do it, you know, and I think that's what we were talking about earlier is some people thinking like, well, if you're a social worker, you better take insurance or else you're whatever. And it's just kind of like what what works for you, you know, like what's your financial reality right now?
Faith (33:03)
Right.
Taylor (33:12)
How confident are you talking about your fees? Because if we're uncomfortable talking about money, but then you're going to be charging, we're taking private pay, like we need to unpack that a little bit, you know? What kind of marketing do you want to do? I think all those things. If, no, go ahead. I was going to ask you a question. Go. Yeah.
Faith (33:17)
Yes.
Right. And also like, yeah, go ahead, Taylor.
Oh
yeah, I was gonna say also like if you're not willing to increase your fees, like we are collectively keeping the profession stagnant or underpaid. So like we need to all be kind of saying every year we need to be raising our fees at least with inflation and I think
what we're doing is really difficult work and it involves a lot of risk and liability and I mean the amount of times you might encounter suicidality or ⁓ abuse or neglect or any of those types of topics you know given a week could be multiple times a given week that's a lot of liability we're holding for families ⁓ being asked to go to court being asked to
I mean, I've been asked to into pulled and pulled into like corporate PTSD issues, divorce issues, especially when you're working with younger clients. It's like, that's a lot of liability and you deserve to be compensated for that. Not only liability, but then that's a lot of emotional work you're doing and labor you're doing. And so that is worth something. And sometimes I would say it's worth more than.
Well, don't want to get cut, cut, cut, cut, cut, cut. I don't want to get into comparing professions. So cut, cut, cut. but yeah.
Taylor (34:54)
Okay. Okay.
What do you have any advice for younger you or maybe social workers who are considering starting private practice? What would you say? ⁓
Faith (35:05)
⁓ in terms of like insurance or private pay? ⁓
Or just in general, you think? In general? Yeah, both. I would say if you are a younger therapist, or what I would have said to my younger self is there's nothing wrong with starting a private practice early in your career.
Taylor (35:12)
Maybe both. I like both. Yeah, let's hear both.
Hmm
Faith (35:27)
Go for it.
There's a lot of stigma about that, right? Like, I haven't been doing this for 10 years, so like I shouldn't start a private practice. Just don't worry about it. Go for it. Nobody actually cares. And if they do, in one ear out the other and keep doing your thing, like just, it's okay. Get support, know your scope of practice. Don't be afraid to root for out and get all the, you know all the things.
Taylor (35:34)
Totally. Yeah.
Yeah, get support while you can get some. Yeah, yeah, yeah, of course.
Faith (35:57)
But there's no reason why a new clinician who just started out shouldn't be allowed to make a salary by doing a private practice. I think that that is totally fine, and if that's what you want to do, go for it. I think I'm all for it. So that would be my little piece of advice. And I would probably say, obviously my situation was a little different, but if I was in the United States, I would probably.
say starting with insurance is a good first step just to get you comfortable with like how this all works and I think it does make you really good at your notes. think you are like you do end up getting like really good at it and then when you go private you're like ⁓ this is gonna take me like two minutes like yes ⁓ but no like I think ⁓
Taylor (36:37)
That's...
Yeah, yeah.
Faith (36:50)
Yeah, just like taking insurance is a great way to just like get started. ⁓ Yeah. So did I? Yeah. And then I think, but if you want to go just straight private too, just, I think that's fine too. It just might take some time to build up your, your caseload. Do your thing. Yeah. Yeah. What a concept. And don't believe people that are like, you have to be really in the field for a long time to do a.
Taylor (36:57)
I love that. Yeah.
Do your thing. Do what works best for you. Wow, what a concept.
Faith (37:18)
No, you don't. We need you. We need therapists. Yeah.
Taylor (37:19)
Yeah. We need therapists. We need a lot of them. Yeah, especially these days. Anyways.
Money moment. Let's get into the money moment. All right. Great chat about private papers, insurance, money moment. My money moment is yesterday I updated our net worth. simple.
Faith (37:31)
Yeah
Taylor (37:44)
⁓ net worth calculator, or net worth, net worth Google sheet. And for anyone who doesn't know your net worth is your assets minus your debts, debts minus assets and whatever the balance is there. So I'm going to say we're still in the negative. Not going to lie. We're still in the negative. We're still in the negative. However,
Faith (37:57)
Mm.
That's okay, we're here for it. Yeah. What do you got
though? What do you got?
Taylor (38:15)
I am just super impressed and excited about like the progress that we've made in the last three years. So May, 2022, this is when we started our financial journey, paying off debt, whatever our net worth was a negative $143,000. Yeah.
Faith (38:21)
Yeah.
Mmm. Oof.
Taylor (38:40)
We had $277,000 of debt. was our, that was the number. And now, our net worth is negative 12,000. Mm-hmm. Negative 12, negative 12,000. And we started with negative 143,000. It's amazing. We've paid off a ton of debt.
Faith (38:51)
What?
Wait a minute. Taylor?
Ha! Dude, that's... that's...
Whoa!
Taylor (39:07)
My investments have grown so much. ⁓ think I started. Yeah, May 2022 I had $10,000 now I have now we now we have 90,000 investments. Large cast it cash savings. We saw student loans, but yes, we're we're on the up and up so. Feeling good.
Faith (39:10)
you
What? Okay. Yay!
I mean, I think that
negative is going to turn to a positive very soon. 12,000? You got this. yeah. You're going to be like, tomorrow I'm good. No, you're like, actually I'm about to make a big payment. No. Are you guys going to celebrate? Are you going to celebrate in some way when you guys hit that? Mm-hmm. You should.
Taylor (39:35)
⁓ yeah. yeah, for sure. Mm hmm. I'm super excited to see that go to zero. When it goes positive, honestly,
like, you know, some people like for the assets.
Faith (39:55)
Celebrate so you go back into the negative. We're taking a trip.
⁓ whoops.
Taylor (40:03)
⁓ Some people count their cars as
assets and like we don't. I'm not counting those, but we both have paid off cars. like are both of our cars together is worth more than 12,000. So it's like, I don't know. To some people, maybe we are in the positive, but I'm talking about assets of cash investments and home equity or houses, which we sold our house. So we don't have a house. So really it's just cash and investments. ⁓
And we don't have any other like things that we. Have in terms of like things that we are and I don't I don't know, you people invest in like gold or I guess we have we have like we we have like three Pokemon cards left that we haven't sold. We still love so I think those are worth maybe $2000. ⁓
Faith (40:35)
This is so exciting.
Yeah. ⁓ because you guys sold a lot of them, which is that was your gold. That was your gold. OK.
Taylor (40:57)
So anyways, we are on the up and up. Wait, sorry, what was your question? Oh, hmm, maybe, maybe, maybe, I guess, I don't know, hadn't thought of that. When we get to zero, yeah, yeah, I feel like we could maybe get there. I mean, a couple months, we'll see, but yeah, that's.
Faith (41:00)
You didn't answer my question. Are you going to celebrate?
Maybe? Why wouldn't you? Everybody, should submit ideas of how Taylor should celebrate this. This is a big deal! This is big deal. You should celebrate.
Taylor (41:26)
That's the update. What do you got?
Faith (41:26)
It's good. Yay.
Definitely not as cool as that, but why did I go last? Why didn't I go first? No. You're screwing me over super hard here. No, ⁓ my money moment, it is in theme with private practice topic that we're talking about, like insurance and private pay.
Taylor (41:31)
you
Faith (41:48)
So Taylor knows that I've gone back and forth on raising my private pay rate I get like really anxious about it like the amount of voice memos I've sent Taylor about I think I should do this and I should do that No, I'm gonna go back to you. It's like outrageous but
This is like what you should not do. My money moment is about like don't do what faith is doing. I have not raised my private rate in four years. Like when I was abroad, was one, I raised it every year when I was abroad. It started at like 120, then it went to 130, then it went to 140, then it went to 150, and I've stopped at 150 like for...
I guess it's three years now and coming back from maternity leave, I raised it $5. I said, I'm at 155 now. And like, I just want to encourage everybody, like, it's okay to raise your private rate. Do it. Don't do what I'm doing. Just be bold and go for it. But like, my money moment is don't do what I'm doing. That's a mistake, right? We talk about like, yeah, go ahead.
Taylor (42:52)
Don't be faith. I know she was like she was like, yeah, yeah, I just was going to say I remember
you being like, OK, I'm going to charge 160. I'm going to raise it to 160. And I'm like, yeah, girl, like power to you trying to empower her. And then I saw her in person. I'm like, yeah, 160. She's like, actually, it's I did one fifty five.
Faith (43:01)
Mm-hmm.
Yeah
like enough to cover my credit card fees for each transaction like seriously now I get like 150 instead of 145 because I added five dollars so it's really not that much but yeah money moments are supposed to be about yeah it's okay to raise your fees and money moments are supposed to be about learning and advice and this is like a learning moment of like I need to just raise my fees and be confident about it and there's nothing wrong with my fees going up
Taylor (43:27)
Raise your fees, it's okay.
Yeah, and I'm doing an investing presentation webinar later today and one of the slides, well, like three of the slides is about inflation and how we expect, you know, the feds, expect...
Faith (43:48)
Yes.
Taylor (43:57)
⁓ the cost of things to go up 2 to 3 percent every year. Like that's just baseline. We expect it, you know. So if you don't raise your rates, then the amount that you're getting every year, you're just able to buy less with with that. Yeah. So.
Faith (44:10)
is less.
Mm-hmm. Yeah, and
if you have a private practice your rent is gonna go up the cost of these EHR or these other services are gonna go up Yeah
Taylor (44:21)
the things that you're paying for is going up, but
your rate's not going up. And so it's okay. It's okay. On that note, everyone, thanks for listening and we'll be back in two weeks.
Faith (44:26)
Yeah, so it's okay. On that note...