Billing Considerations

Cash flow can easily be the bane of private practice. Your accounts receivables can be thousands of dollars while you are struggling to pay rent because the cash has not came in yet. This is especially true with private insurance companies that can take several months to pay. Be sure that you understand billing criteria, forms and timelines clearly if you are doing your own billing. Various software programs can integrate your notes, treatment plans and billing. You can also employ a business platform service or private mental health billing company. Whichever you choose, cash will need to be flowing as freely as possible into the coffers. Here are some tips as you set out to collect money for services

Carefully read the contracts offered by the insurance companies and EAPs before signing up.
Counter with an offer addressing any concerns. You may be able to negotiate higher reimbursement rate.
Understand the specific pros and cons about signing up as in network vs out of network. Some companies pay high rates or in a faster manner for one vs the other.
Collect co-pays for clients immediately.
Accept you will have to talk to your clients about money. Your services are not free.
If you balance bill clients each month, call to follow up on the bill or hire someone to do so.
If a client wants to pay on their bill, let them do so immediately.
Research to see if one provider is a staple of your area. In Wyoming, Medicaid will electronically pay eligible providers every week for valid services. This helps cash flow.
Build a positive relationship with the representatives from the insurance companies, your billing company or your software's customer support line. Questions arise often.
Put away money into business savings for low cash flow times.
You may be able to charge your client at the time of session and allow them to collect reimbursement from their insurance. I find that this payment arrangement leads to clients stopping therapy early due to out of pocket expense.

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Getting Licensed in Wyoming

Depending on your graduate school specialty area, you can find Wyoming mental health provider application materials and requirements on the following websites: For bachelor or master level social workers, licensed professional counselors and psychotherapists, marriage and family therapists, you can obtain the needed application forms from the Wyoming Mental Health Professions Licensing Board at http://mentalhealth.wyo.gov/ For doctoral level psychologists, school psychologists, post-doctoral psychology interns, and specialists in school psychology, you can visit the Wyoming Board of Psychology at http://psychology.wyo.gov/ School psychologists or Specialists in school psychology who wish to pursue a license as a Licensed Professional Counselor (LPC) should contact the Wyoming Mental Health Professions Licensing Board at http://mentalhealth.wyo.gov/

State Rules and Regulations

The mental health licensing board in each state not only oversees the professional and ethical expectations of counselors but it typically outlines which professional licenses can and cannot own own private practices. For instance in the State of Wyoming, mental health licenses that require temporary or ongoing supervision are not allowed to own a private practice. This includes Certified Social Workers Provisionally Licensed Clinical Social Workers, Professional Counselors and Marriage and Family Therapists Certified Mental Health Worker Clinicians that have full licenses (LCSW, LMFT or LPC) typically have fewer restrictions in owning a private practice. If you are uncertain if you can own a private practice, review the rules and statutes posted by the mental health licensing board in your state. Call or email the board directly with any questions not outlined within the state statutes.

Federal Tax Payments

Federal taxes as a self employed individual and for a business operate differently then other employment arrangements. You will pay your typical percentage of tax withholding plus an additional self employment tax. Self employment tax is currently about 15%. The rate consists of two parts: 12% for social security (old-age, survivors, and disability insurance) and 3% for Medicare (hospital insurance). Essentially self employment tax is the amount a company pays on your behalf when you work for them. Since you are now self employed, you are responsible for both chunks of the payment. Depending on how you established your practice as a legal entity alters how the business is taxed. Remember that the legislators of the country reform tax law often and your tax liability may change with new laws. Consider having an CPA in your community complete your taxes rather than an online service. This can maximize your deductions. Keep accurate logs and books throughout the year for

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