The Contract You Already Signed

Welcome to Craft Your Practice Method™ The place where the art of therapy meets the business of practice. You have a contract with every insurance company you are paneled with. You signed it, probably at the end of a long credentialing process when you were mostly relieved the whole thing was over, and there is a fair chance you have not looked at it since. That is not carelessness. Nobody teaches this, the documents are written to be skimmed, and the part you most want to see is usually not in the envelope at all. The contract you signed almost certainly does not contain your rates. What it contains is a reference, pointing at a fee schedule that lives somewhere else and gets updated without the contract ever changing. That is why the answer to what does this payer pay you is so often a shrug and a guess based on what landed in the bank. You are entitled to that schedule, it is not confidential from you, and this episode covers exactly how to ask for it. Then the sentence that quietly costs therapists money every week. Almost every payer contract says they will pay the lesser of your billed charge or the contracted rate, which means if you bill under their number they pay your lower one and nothing anywhere tells you. No denial, no letter, nothing. It looks exactly like getting paid. After that, the four clauses that decide how much money reaches you, all findable in an afternoon: timely filing, the appeal window that starts when they deny rather than when you notice, recoupment and how far back they can reach, and the amendment clause, where in a good many contracts your silence counts as agreement to a change they sent you in the post. Then what the contract says about leaving, including the all products clause that can sign you up for plans you never wanted at rates you never agreed to. Finally, the part almost nobody does. Payers do negotiate with individual clinicians. Not always and not by much, but a request that is never made has a nought percent success rate, and this is what to put in the email. CHAPTERS 0:00 Intro 1:41 The rates are not in your contract 2:42 How to get the fee schedule 3:52 The sentence that quietly costs money 5:52 The four clauses that decide your money 8:14 What the contract says about leaving 10:05 How to actually ask for more 12:25 Decide it on purpose 14:13 The free credentialing timeline If the business side of practice is the part nobody taught you, subscribe and I'll keep teaching it here, one piece at a time.    / @craftyourpractice   THE FREE CREDENTIALING TIMELINE, AND THE REST OF THE LIBRARY The timeline is free. The whole sequence with the real windows, the five stages, and the checklist to run before you submit. The same page holds everything else I've built, more than twenty guides and workbooks plus the courses. craftyourpractice.com/start Nothing in this episode is legal advice. If a contract term is going to cost you real money, a healthcare attorney reading your specific agreement is worth what they charge. Lisa Reidsema, LMHC. More than fourteen years running a private practice, teaching the business side that graduate school does not. #craftyourpractice Get free therapist tools & resources: https://www.craftyourpractice.com/start Explore the Launch Lab: Your First 90 Days in Private Practice: https://lessons.craftyourpractice.com... Follow Craft Your Practice: Instagram:   / craftyourpractice   Pinterest:   / craftyourpractice   Website: https://www.craftyourpractice.com About Lisa Reidsema, LMHC Lisa Reidsema is a therapist, author, and mentor helping new and emerging therapists build aligned, sustainable, profitable private practices without burnout.