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Tricks to Dealing with Insurance as a Provider

how to work with insurance as a mental health provider

As a mental health provider, I accepted insurance for most of the years of my career. As a social worker, I fully understand it is an accessibility issue. Many people cannot front the money for therapy and get reimbursed later. Nor can they afford to pay out of pocket. And in a time when insurance is not free anymore (I do remember those golden years when it was) people want to utilize benefits they are paying for.

However, coping with insurance companies as a provider is often a bit of a nightmare. Recently, I had a client with an out-of-state plan. The person worked through all the hopes to get me approved to see them as an out-of-network provider. They told the client they would have a certain percentage co-payment but were unable to tell the client if my entire fee would be paid. Many insurance companies have a reasonable fee that they will not pay beyond. However, they won’t tell you what that amount is. When I tried to verify benefits, I was told I was not in the system. I tried to bill and the error message was my ID numbers did not match. I had the client call and their insurer left me a message saying submit again. When I tried to call the number they left me I was unable to get to customer service. They said, “That is not an option”.

I used a trick I have used before. I went to the Twitter page of the insurer and DM’d them. I got a call within two hours and the agent told me that I had to bill my local Blue Cross plan, not the plan whose name it was. This was a new concept for me and I googled it and found that when you are billing an out-of-state plan over 90% of the time you need to bill your local plan. Of course, there was more than one local plan but I was able to electronically bill both of them. One of them allowed me to process an eligibility request so I figured that is the one that will pay.

Time spent was over 2 hours. Now I will say had I read the back of the card that was submitted to me it did say submit to local plan. Since historically I had been in network I had never billed an out-of-network plan before so this was new to me. My unreimbursed time spent was about 2 hours. What I took from the experience is that I won’t make exceptions and accept insurance anymore because it is too time-consuming.

This is what has happened to many therapists across the country. Some aren’t in a position to say they won’t accept insurance so they instead spend hours of unreimbursed time trying to get paid. For those of you who accept insurance, I wanted to share the billing information locally and on utilizing social media to get assistance. I have done this numerous times and it has always worked. They seem to have a very competent staff working the social media issues.

What to Know About My Upcoming Nuts and Bolts of Private Practice Workshop

I am doing my next Nuts and Bolts of Private Practice Class on September 22m 2023 from 9-12:30PST and 12-3:30pm EST. It will be recorded and accessible after the day of the workshop.

I have been doing this workshop since 2011. I was asked to present to some students at SFSU in the social work program. These students were thrilled with the presentation and hungry for more information so I developed this workshop. It has evolved over the years to include new issues and requirements such as the Right to an Estimate Paperwork and a more extensive presentation on telehealth. If I know what state you are in I will include that states requirements in the presentation. However most of the issues are those that we all face. Logistical issues like getting your NPI and EIN. Creating your paperwork. Picking an electronic health record system.

I have been in practice for more than 20 years and have a lot of experience and wisdom on having a successful practice. Including having worked through two recessions. I have been on insurance panels and now I am not and can offer you some ideas and thoughts on that.

Feel free to email me with questions. To register click here.

Content Length for SEO on your website

SEO Content is King

In today’s world, search engine optimization (SEO) is essential to increasing a website’s. One important aspect of SEO is the length of website content, as it directly impacts search engine rankings. While there is no definitive rule regarding ideal content length, it appears longer content ranks better. However, other factors can determine the best content length for your purposes.

In the world of SEO, what is known as user experience is essential. People want concise and informative content. Short content may lack depth and leave visitors wanting more, while excessively long content can be overwhelming and discourage engagement. The key is in striking a balance that delivers valuable information in a digestible format. Google’s algorithm aims to present users with content that comprehensively answers their questions, thus rewarding longer, comprehensive articles.

Search engines utilize algorithms to determine the relevancy and quality of website content. While length is one of many factors considered, it holds much significance in search engine rankings. Longer content can incorporate more keywords and relevant information. They can also generate higher user engagement, such as increased time on the page, social media shares, and comments. These user signals are valued by search engines, signaling that the content is valuable and authoritative. This can improve your SEO ranking

When you determine your content length you should strive for a length that covers the topic, meets user expectations, and maintains readability. Aim for a balance between depth and brevity to engage users while also meeting search engine requirements.

I also recognize real-world issues. It takes a lot of time to write good content. Time we might want to spend resting or doing paid work. When I researched this topic I saw recommendations of 2,000 words for blog posts. This post will not even come close to that. For this post, I feel that length would mean many of you would stop reading. My recommendation is make your points, but don’t over-emphasize length and lose readability.


SEO Tips for Therapists

I have been having some fun on Instagram lately. Follow me at @growyourcounselingpractice. And in the spirit of now focusing on working more on my Search Engine Optimization, I am using Instagram to provide tips on marketing and building your private counseling practice. Using social media is a great way to improve your Search Engine Optimization performance. Then by taking the videos and posting them here and adding additional content I am providing fresh content on my website. Though, I am not following the recommendation I am making to have at least 600 words of content on each page or post. One can only work so hard.

These videos explain SEO, discuss the importance of social media marketing, and talk about how much content needs to be on each page.

I also want to remind people of my SEO course. This course takes you through the basics of improving your SEO. Even if you are paying someone else to do this work for you, it is good to have an understanding of what helps search engine optimization. Many companies will take advantage of your ignorance. The course takes you through different aspects of Search Engine Optimization by giving it to you in bite-size portions. I also include some worksheets to help you through making changes. As always I am also available for consultations. 

You can check out my blog for other SEO tips.

There are a few different recommendations for how much content should be on each page to improve SEO. A minimum of 600 words is now recommended and 1000 words are also recommended. You may need to add content to your web pages. I get it. It can be hard to do. I am barely going to make the old guideline of 300 words for this post. I am hoping my use of videos helps give the page some juice.

Quick answer is yes. You need business social media account to promote your business. Both to improve Search Engine Optimization performance and to use as a marketing tool. I suggest finding one platform you are comfortable with and working that. Tik-Tok is super popular now. I had some privacy concerns about it so I have moved on to Instagram which has been effective for my needs.

Creating a Video for your Counseling Website

Creating a Video for your Counseling Website

Today I made a video to show you all how easy it is to get a video on your website! First I bought a tripod. Here is a picture of what I got. It is no longer available but you can find something like it at the vendor of your choice. It was $15.99. It is then super easy to create your video. Well that is a bit of exaggeration. I spent a bit of time fiddling around finding a good angle for the film and a few practice runs.

picture of tripod for iphone

Here is what you do over on YouTube

This picture is off the upper right. You can see the blue icon which shows me it is my channel and then you click the red create symbol to upload your video)

Then you move the video over to your computer for upload to YouTube. Then you upload it. Here are a few screen shots to show what that looks like. Once you have it uploaded there you can access the sharing link. That is the link you will post on your website to show the video on your website.

upload video screen for Youtube

This picture shows where you drag and drop your video to YouTube

YouTube link shown

Here is a picture of what it looks like when you put the link into the website. This will look different on every website.

That is how you easily get a video up on your website.

Is Your Counseling Practice Prepared for an Economic Downturn?

Is Your Counseling Practice Prepared for an Economic Downturn?

In a Facebook Therapist group, a person recently asked a question about how people had experienced their practice during past recessions. The answers varied as one would expect for a variety of therapists in a variety of places. As a person who practiced in the SF Bay Area during both recessions in 2001 and 2008, I wanted to add my feedback. The Bay Area was hit very hard by the recession in 2008. Many people lost their jobs. During that time I was seeing insurance clients and I did not struggle at all during the recession. One of my suitemates did not accept insurance and did struggle quite a bit. 

Therapists have their reasons for being on or not being on insurance panels. In some areas of the country (like the Bay Area) most therapists do not accept insurance. They can sustain their practices with private pay clients only. Because of the high incomes of many people that live there, that is a possibility. In many other areas of the country that is not a possibility. It is so dependent on economic situations. However, it is important to remember that economic circumstances can change. 

We have been hearing for several years that a recession is coming. We certainly know that high inflation has made many people reconsider how they are spending their money. Therapy can be considered a luxury item for many. Not just for those paying the full fee but for those with co-payments. 

How do you plan for or try and sustain a counseling practice if there is an economic downturn?

  1. Have a specialty that is recession-proof. What specialties will people pay for even if times are tough? Two easy ones are working with children and couples therapy. People will often find money to help their children or save their marriage. 
  2. Diversify your practice. What can you add? Groups, consultation, coaching, or teaching or creating an online course. Having a diversity of offerings can keep you going during tough times. Having any type of passive income is awesome. I have some online classes. They were a lot of work to develop but once they were done they have become a source of passive income. I don’t have to do anything but collect the fee (and of course check in every so often to make sure the content is up to date). 
  3. Expand your skill set. Learn a technique that is in high demand. During the pandemic, I used the time to become both certified in EMDR and a consultant. This has helped me both be a better therapist and diversify my income by adding consultation to my offerings. 
  4. Stay connected with other therapists. This is different now in these post-COVID times. Many of my therapist relationships have started online. I am in at least ten different therapist Facebook Groups. I have to target where I spend my time. I focus on EMDR groups to allow me to be seen as a knowledgeable resource for people. Most of my consultation groups have been recruited for on Facebook. I understand the real issues about social media and the good and the bad. To have a practice in 2022 and on and not be engaged in some social media is to restrict your marketing. People like to make referrals to therapists that they know and knowing someone on social media counts. 
  5. Start making videos and even better do them and post them on TikTok. Videos are an easy way to get your name out there. You can almost do video blog posts. Give your thoughts on things related to your practice. A YouTube channel helps your SEO and can build your brand. TikTok is the new wave of social media. People like quick bits of information. The attention span of the average person seems to have dropped, so short content is more effective. Make sure you share your content on social media and use a great picture in your post. This is a marketing tip, but it is even more essential to make yourself stand out during tough economic times. People want to feel like they are getting their money’s worth and working with the best person to help them. 


I would love to hear your feedback about how you have handled different economic circumstances in tough economic times. Feel free to post in the comments. 

New CEU Requirement for CA licensees

New CEU Requirement for CA licensees

The Governor just signed AB 1779 which requires that all licensees and people getting a license for therapy in CA get three hours of coursework in Providing Telehealth effective July 1, 2023. If you completed such a course in the past find the certificate and make sure it is in your CEU packet for the year starting July 1, 2023. If you are audited after 2023 you will need to provide documentation that you took this coursework. Here is the BBS FAQ on this requirement. 

There are some new legal and ethical requirements for associate registrants. Each year before you renew your registration you must take 3 hours of CA Law and Ethics coursework. If you fail the Law and Ethics exam you will no longer have to take a 12 hours Law and Ethics class before you take the exam again. Here is the BBS FAQ’s on this. 

The BBS also implemented AB 1758 which, is in regards to, the Supervision of Applicants for Licensure via Videoconferencing. Effective August 29, 2022, supervision can now be via video. Here are the FAQ’s on that. 

The entire law can be found here. 

4 Tips For SEO Optimization of Blog Posts

4 Tips For SEO Optimization of Blog Posts

Since most therapists have what is called a static website (there are not often changes or new content added) we have to add fresh content in different ways. The blog post is one of those ways. Frequent blog posting can engage your potential clients and help your SEO. First, I must say, the most important, tip in content writing is ALWAYS writing content your reader will be interested in. If you write boring content, it does not matter how many people come to your pages because they won’t engage. 

Many of us are also trying to market in multiple locations, which is quite hard. I market in both PA and CA for my counseling services. I have intentionally optimized different pages for different states. However, that won’t necessarily be enough for many of my keywords. My Bay Area optimization has decreased since I moved and tried optimizing in PA. In order to get Google reminded about my Bay Area work, I recently wrote a blog post called Bay Area EMDR Intensives. My keywords were location (Bay Area, EMDR, and EMDR Intensives. Sometimes it can help us rank by working with less competitive keywords. EMDR Intensive is going to be less competitive than counseling will be. I may not rank for counseling but I am ranking for EMDR intensives. 

4 SEO Tips for Blog Posts

  1. Develop a strong headline. This headline should use one or more keywords. A title with a number in it gets clicked more often. 
  2. Google is suspected to be rewarding longer posts. Write a minimum of 300 words and strive for 1,000 words.
  3. Use headings to break up content. You can see how I did it in this post. There is a heading that says Writing Good Content for SEO Optimization and then a second one that is in a small heading font that says 4 SEO Tips for Blog Posts
  4. Have strong page titles and page descriptions. Do this on all pages and posts. You do this behind the scenes of your website. Below you can see a screen shot of a google search for EMDR intensives in PA. One of the counseling pages I targeted for those keywords did show up. I am indicating what the title is and what the description is.

Keeping fresh content on your website is an ongoing task. It is easy to forget and then a year goes by without posting. (2020 anyone?) However, it is important to keep up this work, and if you get off schedule, just start up again. 

Build Your Private Practice Counseling Practice With Work-Life Balance

Build Your Private Practice Counseling Practice With Work-Life Balance

In the summer lull? Are you enjoying it by spending more time with family or doing fun things? Or are you worried because your August income dropped by 40%?

Many of us have taken the changes created by COVID into our brains and are looking more and more at our work and questioning if it’s part of a good work-life balance. I know I am not the only therapist that is seeing fewer clients and trying to create other income streams. For me I have developed an EMDR intensive program, I do this work, and I have become an EMDRIA EMDR consultant. My goal is to continue this and maybe even add some additional teaching work. Because teaching invigorates me. 

As many may know, I recently undertook a major life change. I moved back to the East Coast to PA. After almost 30 years in the Bay, it was time for a change. In PA, the cost of living is so much less that it means I can work even less. I can also spend more time doing the things I want like riding my bike and starting some volunteer work. For others, they want to create a schedule where they can meet their kids’ needs, live on the road for a bit, or even leave the country. With telehealth becoming common it gives many of us many more work and scheduling options. 

I want to help you figure it all out. How to have a good work-life balance. How to do the work that energizes you. How to make the income you need. Then I will help you get there.

Like most of you, I hate to toot my own horn, but people that take my classes and work with me love my super authentic and pragmatic nature. I have had my own counseling practice for over 20 years. I have seen a lot, and I am happy to share that knowledge with you. Email me to set up a free 15-minute consultation to see how I can help you set and reach your business goals for your counseling practice. 

I am offering a 15% discount for services purchased through Labor Day. Mention reading this blog post to get it. 






Making Video Content for Your Website-You Need a Video!

Making Video Content for Your Website-You Need a Video!

Video content on your website is a great way of connecting to your potential clients. Over the years, I have done several videos for my counseling website. The first was made with an actual video camera. Subsequent ones have been made using my computer or iPhone. Today I just made a new video using my iPhone and using a tripod selfie stick with a remote. This means no awkward lean-in and lean-out to turn off the video.

Since we can make videos about ourselves now there is NO EXCUSE for not doing it! I know you will come up with some like I don’t want to see myself! I get that for sure. I hate watching videos of myself. As I recorded today’s video I must have done 10 takes. My shirt was the wrong color. My shirt had lint on it that showed up dramatically in the video. I said UM too much. But it is important to persevere. Clients need to make a connection with you and if you are not seeing people in person your website is how you are going to make that connection.

Once you create the video you may or may not want to edit it. I put my video into Imovie and was able to clip the end a bit. It took a second for me to turn off the video (even using that remote) and it seemed awkward so I just clipped the video two seconds.

When you are done you upload the video to YouTube. You should create a business account there for this purpose if you don’t have one already. You upload your video, put in a good title and description using your keywords, and publish it.

YouTube will give you a link that you can then post on social media or on your website to showcase your video. Look how I did it here.

Having videos on your website will both help engage potential new clients and help with your SEO. It is a win-win.


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