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If You Can’t Keep the Lights On, No One Benefits!

Many behavioral health agencies, and in particular those focused on autism treatment, are established out of a desire for clinical freedom. The founders of these agencies are rarely MBAs or suit-clad business men or women, but rather clinicians frustrated by working for someone else.

What this means is that caring and passionate clinicians are now “business owners” burdened with the everyday administrative, managerial and financial headaches they likely didn’t take into account when they decided to hang out their solo clinical shingle. Making sure that there’s money to pay the bills, that accounts receivable are on track and payroll is covered are just a few of the “business” issues that keep them tethered to their desks.

So, how do you make sure that the lights actually do stay on and your business stays afloat?


There is no easy answer but there is one thing you must do: Make sure you are being suitably compensated for your services.

That probably sounds like a no-brainer, but do you know what “suitably” actually means for you, in your practice? If you do not know how much it “costs” you to provide services, you don’t know what “suitably compensated” means either. Everything, and I mean everything, you pay for in order to keep the doors open must be included in your “costs”. Have you included the big expenses like your rent and payroll? How about smaller expenses like office supplies and utilities? Taxes? Insurance? Travel expenses? Continuing education units?

Your actual cost of providing services, taking all your expenses into account, is a figure you must have before you can accept (or must reject) the terms of ANY contract offered to you, and that includes insurance companies’ contracts. Your cost (plus any profit margin you decide, if any) has to be your “line in the sand” which you will not cross under any circumstances.

It’s tough to decline a contract particularly when you have families lined up and waiting for you to become an in-network provider with the insurance company that’s offering you those same un-suitable rates. But, consider the alternative: you sign the contract, provide services at a loss to more and more clients as they get referred to you, can’t meet your financial obligations and, voila – it’s all over for everyone. If you agree to provide services at a loss you run the risk of watching all your hard work come to an unfortunate end, shuttering your practice to all the clients and families that rely on you.

Conclusion: Do your homework in advance so if a rate below your “line in the sand” is offered to you, you know that it just won’t do!

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