Information for Therapists
NEW!! Article by Dr. Ivan Miller: Doctors and Psychologists Don’t Hate Science —They Treat Real Patients: A Reply to Sharon Begley and Newsweek
Article: Self-Pay Clients, Not Insurance Companies, Deserve A Discount
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If you are interested in joining the Guild, please call us at 303-444-1036 or send an email to boulderpsychotherapistsguild@gmail.com. Put the words 'Requesting joining information' in the subject line of your email, and please include your mailing address and telephone number. You will receive an information packet via return email (PDF format), and the Guild manager will call you to follow-up. If you would prefer a hardcopy of the information packet, please include that request in your email.
Available Office Space Listings
- (4/1/10) Modern, spacious office with shared waiting room near Boulder’s Foothills Hospital. Large enough for families and groups. Very convenient location with ample free parking and close to public transportation. Available all Friday. For more information, call Sharon at 303-444-2003.
- (10/2/10) Chic downtown space with fabulous SW-facing deck for between-session restoration. Furnished in clean, modern style with brand new Ekornes/Stressless chair. This is the best office. I love it here and so will you. The office is in a suite with other licensed, established therapists. Amenities include: waiting room, group room, Internet & fax, tea/water/coffee service, your after-hours parking space, lovely courtyard and the delicious Arabesque Cafe below. Office is available Tuesday / Thursday after 2:00, any evening after 6:00 and all weekend. $185/mo. Clients always seem to ask for Saturdays. Please call Sara 303-443-3637. I can show it to you today!
- (11/25/10) Peaceful, very attractive office space available for sublet on the first floor of the Tree House Building at 737 29th Street, just off of Baseline and 28th. Great location to see students and clients from Denver. This private first floor office has its own waiting room, bathroom and deck off of the sliding glass doors looking out on a little pond and lovely trees. It also has cork floors and fresh paint. Building houses healers and therapists as well as a yoga studio. Available Monday or Tuesday and Thursday at $150 a month for one day and $275 for both days. Prefer to begin January 1 but can negotiate an earlier start date. Short term sublease through the end of April or May also negotiable. Call Anne at 720-839-4741.
- (12/6/10) Lovely, FURNISHED, WEEKEND office, for counseling, massage, and/or small yoga/healing classes: $90/Mo. for Saturdays, $75/mo for Sundays, $150 for both days. Near 30th and Arapahoe in Boulder, with a Zen garden atrium. Large 10x18 reception room and even larger 10x20 session room, big enough for groups. Large windows that open, 10 small and large plants, designed by an interior designer, Chinese, Japanese, and Nepalese art. Antiques. Elevator and covered parking Quiet, with extra insulation for sound. Hot/cold bottled water. Please call Jim at 303.534.8717 for a showing.
- (12/14/10) A prime office location in building within long-established medical practice on Spruce and 26th. I am looking to lease with a flexible schedule that would work amicably for all. This office comes with a separate waiting area, bath. It has been newly decorated in an urban style within this original brick historical interior. There is a separate area that is used for office or play if needed. The office is handicap accessible with ample parking. I am looking for a licensed psychotherapists or certified coach who would love to collaborate with me in my practice, Pursuits Coaching and Psychotherapy, Inc. For more information, please contact Sharla at 720-304-2731.
- (12/26/10) Psychotherapy office space to share in charming building in downtown Louisville on Front Street. Parking, handicap accessible, kitchenette, waiting area, clean, quiet, secure building. $120 for all day (and evening) Wednesday as well as shared time, as available, on Friday, Saturday and Sunday. Includes WIFI, air conditioning, heat, cleaned restrooms, and snow removal. Close to great restaurants. Office space is good for couples and individuals. Conference room available for groups and larger families. Building houses psychotherapists, massage therapists, and other healing professionals. Official start date would be January 15th 2011 but could start January 1st. Space available for showing now. Contact Roz at 303 378-1887 or rbardpsyd@infionline.net
- (3/22/11) 3 offices for rent at 1530 55th Street, just SE of 55th and Arapahoe in Boulder. Other therapists and businesses in this easily accessible building.
Suite 119, 166 sq. ft., $350/month -- Suite 121, 130 sq. ft., $250/mo. -- Suite 128, 89 sq. ft., $200/mo.
All 3 are "3 months rolling lease, security of one month's rent, and available with 1-2 weeks notice. For information or showings, call 303-444-3051 or inquire within between 8:00 A.M. and 5:00 P.M., and ask for Tammy.
5/1/11) Office sublet available for a therapist, Fridays only, nice central Boulder office with views of the Flatirons, waiting area, wheelchair accessible, three other therapy offices, great building, excellent parking. Call John Rifkin at 303-442-8652.
(5/11/11) Upscale Psychotherapy Office in historic landmark home, The Arbor House, on east Pearl. Office has pitched ceiling, west and north facing opening windows, soundproofing, individual heat and air conditioning, built in bookcases, elegant furnishings. Amenities include kitchenette, central office with fax, copier, wireless internet, personal parking space, homey waiting room with tea service. Seven psychotherapy offices in the building makes for peace and quiet. Collegial relationships are warm and inter-office referral network is strong. When clients walk in the room they want to stay. Must be licensed in your psychotherapy discipline. Office available on Monday, weekday evenings after 6PM, Saturday & Sunday. Rent to be determined by the number of days; would consider renting hourly at $15 per hour for a minimum of 3 hours per week. Contact: 303-449-6878 Dr. Ina Robbins. See Craigslist for photos.
NEW LISTING! (7/4/11) Share/sublet office in Downtown Boulder! Office is wonderful, with bay windows, lots of light, high ceilings - must see! Available Mondays, Thursdays, and Fridays, plus weekends and evenings. Call Ginna at 303-444-4966.
NEW LISTING! Available July 1. Sublease for new office space at 2935 Baseline Road, Suite 302, Boulder. Suite of three offices with private waiting area, storage and kitchen. Office ideal for therapy with children or adults, individuals or families. Newly furnished. Days available Monday all day, Tuesday and Wednesday 8-12, Friday morning or afternoon and all evening. Rent $ 150/day. Contract required. Please contact Mary for more information and to see space. 720-482-0069.
NEW LISTING! (7/4/11) Lovely First-floor Office Available August 1st for year lease, $380/month includes utilities, good water and weekly cleaning, in homey setting with established therapists. Opens onto a quiet tree-lined courtyard with other townhome-style Broomfield professional offices with ample free parking. Office is 150-plus square feet enhanced by high-rising ceiling, large window, mantle with fireplace and small alcove. Office room has been soundproofed, on first floor next to waiting room; and subletting is possible. Please contact Ahmee Hewitt, LCSW at 303- 465-6282 or Marge Theeman, PhD at 303-692-4897 Photos possible by email, and we are happy to give you a tour.
Self-Pay Clients, Not Insurance Companies, Deserve a Discount
Copyright ©2004 Ivan J. Miller, Ph. D.
(Published in 2004 in the Independent Practitioner, 24(4), p 166-167.)
I am often asked about the legality and ethics of giving self-pay clients a discount so that they pay less than an insurance company. I am asked about these discounts because I am President of an organization of 78 psychotherapists in Boulder, Colorado, the Boulder Psychotherapists’ Guild, Inc., and we offer clients a 20% discount on individual and family therapy when they pay at the time of service, and there is no paperwork for insurance or any other party. If properly done, this discount is legal and ethical, and moreover, it makes sense, is good business, and does not decrease income.
Strangely, in the perverted world of health care financing, most insurance companies insist on a discount but many clinicians worry that it might be illegal to give a discount to a client. Insurance companies receive the discount in spite of creating paperwork, putting therapists and patients on hold for long time periods when they phone, losing enormous quantities of mail, mismanaging accounts, invading privacy, and generally lowering the quality of life for almost everyone who deals with them. Yet the self-pay client, who is easier to care for administratively due to the absence of insurance bureaucracy, has historically paid the highest fee. This is not only unfair, but it is a poor business practice to make the least time consuming clients pay the most money.
In 1994, when I established the Guild, I decided to address this unfairness. As an organization that is not only dedicated to preserving the integrity of client-focused psychotherapy, but is also intent on serving consumer needs, the discount was incorporated as part of our commitment to consumers. We have two rationales. First, the advertised discount is promised only to clients who state in their initial contact that they are referrals through Guild advertising. As such, the discount is offered in the same manner as discounts are offered to any participant in an insurance plan that has negotiated a lower rate for its members. It is a group discount that could be offered by any businessperson to any group such as seniors, veterans, or professional colleagues. Second, and more general, is the rationale for the discount that I offer in my practice. I give a $30/session discount to any client who pays at the time of service and does not require a statement that can be submitted to insurance or other paperwork. I explain the reason for the two fees is that I have two levels of service. One level, the discounted service, is consultation and therapy. The second level is consultation and therapy plus hassling with insurance companies or other third parties.
The discount is actually just a method of appropriately pricing services. In other businesses, shipping and handling charges or other administrative charges may be added on top of the sale of a product or service. It is no different than offering a cash discount because it saves administrative and billing expenses. In dealing with insurance, however, the additional expenses cannot be specified in advance and need to be spread over all insured. As clinicians are well aware, the expense of dealing with insurance is enormous. The hours of pursuing mishandled claims are extensive. When clients submit their own claims, I have still found that insurance can ask for additional paperwork. Even an insurance company that has historically handled claims efficiently and properly can change management and institute onerous practices. Today’s good insurance company can have a financial crisis and become tomorrow’s typical insurance company. It is good business to charge differential rates for the two levels of service.
I have found the price differential between the two levels of service appropriately compensates me for my time. When I bill insurance, I find that the higher fee merely covers the hours of my time dealing with insurance, the stress of dealing with industry-wide incompetence, and insurance company induced brain damage. Because I am compensated, I have a better attitude than when I was dealing with insurance without extra compensation. Furthermore, I have the good feelings that come from knowing that I am not asking my self-pay clients to absorb expenses that are imposed by insurance for other clients. I do not lose income because each level of service is priced to pay for its actual costs.
Fortunately, I do not need to worry about breaking any contractual arrangements with insurance companies because I have not signed any contracts to work for insurance companies. I am always an out-of-network provider. I could not do this if I had agreed to a contractual rate with a company.
In order to keep the two levels of service distinct, I do not give self-pay clients a statement that can be submitted to insurance. I do not include a diagnosis on these statements and sometimes do not include a procedure code. In fact, I do not routinely give statements to self-pay clients unless clients request them. If asked, as a good businessperson, I am glad to provide a statement. These diagnosis-free statements are good enough for clients who have a pre-tax cafeteria plan or medical savings account. They also are good for income tax purposes.
My higher fee for counseling or therapy plus paperwork applies not only to insurance but also to any other third party payer who requires paperwork. One example is the victim’s compensation funds that require progress reports and treatment plans.
Over the past ten years, I have had a few clients who wanted the lower fee, and still wanted a statement that they could submit to insurance. These clients said they would endure the insurance hassles and thought they deserved the discount. I have refused these requests for two reasons. First, I am not going to submit different fees to insurance companies. I have only one fee that goes on insurance statements. Second, I have found that any time insurance is involved; it can turn into a mess. I know how my business works and the potential hassles and the policy is based on that knowledge. I did lose a few clients, but in each case, the potential clients were looking for therapy as a way to manipulate or please someone in their environment. These potential clients seemed to place little value on their therapy and wanted to spend as little money as possible while complying with the requests to get therapy. They were not clients who were unable to afford therapy, and if they were I would have negotiated a sliding scale payment. Overall, I believe my policy makes sense and my clients do as well. Typically, clients emphatically and supportively say they completely understand.
To obtain the discount, I ask clients to pay at the time of service in order to reduce book keeping and administrative expenses. Of course, some clients forget to bring their money. In these cases, I simply explain that I have a system for when clients forget and hand them a self-addressed and stamped envelope so they can mail the payment. Often, when I am putting the stamp on the envelope my clients generously offer that they can provide their own stamp. In response, I politely say that I want to make it easy for them to send me the money. In this exchange, my clients understand that I am serious about the payment at time of service but also am understanding that people can sometimes forget.
I have been asked if it is illegal to charge insurance companies more than clients for the same service. I believe that is illegal, and that there may be insurance fraud laws that specifically prohibit charging insurance more than the established rate. However, this is not what I advocate or do. I have different levels of service. I understand that we should set our fees for each type of service and not raise fees for one customer unless there is a policy with a rationale. Once fees are set, we can offer discounts for insurance companies, payment at the time of service, sliding scales, or what we call in the Guild, “no administrative services” discount. Each of the discounts should have a sensible rationale, and it would be unethical to charge a client or an insurance company more on an arbitrary basis or just because they could pay more.
Having advocated discounts for self-pay clients, there is one caveat that I need to raise. Insurance is regulated by state law, and anyone who offers clients a self-pay discount should review all state laws on insurance fraud and professional billing policies. These state laws may change the way that discounts need to be offered.
Discounts for self-pay clients make sense. They also make a statement that insurance should be paying the increased administrative costs of delivering health care. Let us give the self-pay clients the break they earn by keeping us out of the insurance quagmire.
