Billing for Therapy

Billing for Therapy

Display professionalism when you are billing for your therapy services.

Q: Should therapists charge less for telepractice sessions than they do for same-location sessions?

Don't use two different rates for your time. There is a risk that telepractice service delivery will be devalued if we charge less for telepractice sessions than same-location sessions. Your time is your time.
 
Be loyal to your telepractice colleagues. You might find that telepractice limits your ability to do assessments and therapy the old way. You might feel that it is not as good as being in the same location. Be careful. This is only your experience so far. It is a steep learning curve and others are further along. Your colleagues might be experiencing unprecedented success as telepractice professionals.
 
Let me emphasize that concept again. You are billing for your time in offering clinical services. Don’t use two different rates.

Q: Should I ask funders to give consent for telepractice service delivery?

Insurance companies and funding agencies require your dates of service, your hourly rate and the length of your session. Most of them want to see the words “assessment” or “therapy” on the invoice.
 
In my opinion, there should be no requirement to specify if the session was delivered by telepractice. Imagine how silly it would seem to ask a funder for permission to provide services at a small blue table. I believe that in the future telepractice will be recognized as a normal type of service delivery. It won’t be seen as something that requires consent from a funding source. I should add the disclaimer that this not necessarily how insurance companies and funders are currently responding.
 

Q: Should I bill for software licenses that I am using in therapy?

No, the software that you need for your clinical caseload is your expense. Most funders have no interest in reimbursing you or your client for software. Furthermore, it conveys a lack of professionalism to ask for funding for any kind of supplies or expenses. I came to this conclusion early in my career, when I billed a client for a long-distance call. The client laughed at me. 
 
Don’t add unnecessary details to your invoices. Just set your hourly rate high enough to cover your expenses. I used the generic description “speech language therapy services” on all my invoices. I paid for online licenses and shipped commercial therapy products to clients at my expense. I encourage you to define your services as therapy, not software or product sales. 

Q: Should I bill for asynchronous services?

Yes. ASHA’s definition of telepractice is a brilliant, future-proof definition. Synchronous service is easy to comprehend. Your client is in attendance. Take a moment to reflect on services that you provide that are asynchronous or a hybrid. Do you bill for time the time you spend looking at user generated data on a server? Traditionally, therapists would call this “monitoring.” 
 
Do you bill for assessments and progress reports that are generated by software? You should. Those reports guide your therapeutic process.

How we communicate with funders will shape the future. Let me say it one more time, your time is your time! Don't devalue the asynchronous methods that help your clients reach their goals. As a telepractice professional, your clinical services will look different than they did in the past. Embrace this concept and teach others to embrace it.




Business Platforms for Therapists

Business Platforms for Therapists

Business platforms for therapists integrate functions that a therapist needs.

Q: Which platform offers that best integration of the functions that a private practice therapist needs?

 The biggest shortcoming of most platforms made for private practice therapists is that the traditional philosophy of selling time is baked into the features. It is rare to find a platform that gives therapists a custom website and ways to generate income from digital products, group programs, online courses and asynchronous coaching behind a login. 
 
In my opinion, having multiple income streams that don't rely on subcontractors is the best way to build a profitable therapy business. In my own business, I designed several Wordpress website to give me this result. It took me more than 10 years. The technical glitches were endless. I don't recommend this route.
 
Instead, I highly recommend the AttractWell platform for private practice therapists who want their website, marketing and online curriculum to be completely integrated. Zoom, online forms, online appt booking and everything else you need is included. 
 
  • Attract Well (attractwell.com): This is the only platform that I recommend for private practice therapists who want to generate multiple income streams rather than relying on their time as their sole inventory. You can create and grow a business on this platform. My personal link gives you a discount to get started.

Q: Which clinic management platforms are a good fit for Canadian therapists? 

Most clinic management platforms are designed for appointment bookings, clinical notes and invoicing. The traditional philosophy of selling your time as your sole inventory is baked into these platforms. The ones that include video conferencing are designed to mimic a doctor’s visit. They might not offer interactive features like playing videos, sharing audio across devices, and using a whiteboard. The following are a good fit for Canadian therapists who are interested in keeping their data in Canada.
 
  • Doxy Me (https://doxy.me/en/):This is promoted as a telemedicine solution for clinics, hospitals and health systems.
  • Therabyte (https://therabyte.app/): This software was designed for SLPs and OTs. It features client booking, documentation, goal tracking and invoicing. It's a BC company with servers in Canada and the US. The video conferencing feature is called Therabyte Meet. 
  • Jane App (https://jane.app/): The Jane platform is for healthcare providers like physiotherapists and chiropractors. It offers online booking, charting, scheduling and invoicing in one system. This company is based in BC and has multiple servers in Canada, plus servers in the UK, the US and Australia. They have an internal payment processing capability which works in Canada and many other countries.
  • Owlpractice (https://owlpractice.ca): This Canadian platform offers online clinic management for mental health, allied health, SLPs and OTs. The video conferencing solution is called Owl Video Therapy.
  • Practice Better (https://practicebetter.io): This platform was designed by a dietician and her husband. It has a number of features specific to the wellness industry and also offers integrations with wellness apps. It offers integration with Zoom rather than providing a lesser video conferencing solution. 
The following platforms are also popular with therapists. Even though the data may be hosted on servers outside of Canada, the level of security is high. Many of these have in-app video conferencing or the option of integrating with Zoom as an add-on. Here are some examples: