Should You Take Medical Insurance or Go Private Pay?

Should You Take Medical Insurance or Go Private Pay?
Should You Take Medical Insurance or Go Private Pay?

Should take insurance in your private practice or should you go private pay? Whatever your private practice is, it’s a big decision whether you want to go the route of private pay, which I did in my group practice or if you want to go the route of insurance. Each side has its own pros and cons

First Think About This

Where do you enjoy your time? Do you like marketing, networking, branding, building up who you are as a practice or does that feel overwhelming and draining? Or do you like building systems and processes and making sure things flow like it should, really detail-oriented and you’d like to have that consistency.

Those are two kinds of different ways of thinking about things and it doesn’t mean that you have to be on one side or the other. But when you’re putting your time into building a private pay practice some of the things you need to know is:

  • It takes more work in regards to networking, branding, blogging, and getting your name out there. Because you have to prove to people you are worth for people to pay out of pocket and then submit to their insurance. Compared to the medical model most people are used to by just showing up, paying a copay, maybe paying part of their deductible and having you be a provider through that insurance company.

Private Pay Pros

  • You can charge whatever you want
  • Get paid right away
  • You can focus in on a smaller amount of clients in a certain specialty
  • Less paperwork
  • And less risk of an audit

Private Pay Cons

  • Work harder to prove your worth, you have to be able to say here’s the transition people experience: I help [pain] to [outcome] through [methods]

Medical Insurance Pros

  • Placed on panel, your name is out there which makes it easier for Doctors to refer to you
  • Easier to scale
  • You can be a generalist
  • Systems begin to grow outside of yourself

Medical Insurance Cons

  • Don’t get paid straight away
  • Need to do billing correctly, it’s recommended that you hire a biller. We recommend Practice Solutions
  • You need to have an EHR. We recommend Therapy Notes use promo code ‘Joe’
  • If  your systems break down, or you don’t have pre-authorisation, you don’t get paid

Other Things to Think About

  • Your community
  • How many clients do you need to be profitable

If you want more resources like this we have over 30 resources over here!

Joseph R. Sanok, MA, LLP, LPC, NCC

joe-sanok-private-practice-consultant-headshot-smaller-versionJoe Sanok is an ambitious results expert. He is a private practice business consultant and counselor that helps small businesses and counselors in private practice to increase revenue and have more fun! He helps owners with website design, vision, growth, and using their time to create income through being a private practice consultant. Joe was frustrated with his lack of business and marketing skills when he left graduate school. He loved helping people through counseling but felt that often people couldn’t find him. Over the past few years, he has grown his skills, income, and ability to lead others, while still maintaining an active private practice in Traverse City, MI. To link to Joe’s Google+


Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.