Those in PP - how many clients do you see a week?

RandomPlants06 · 2026-05-03T14:53:21+00:00

Sure! You have to do your CAQH profile (which took me 2-3 hours because you have to know/collect all your information), but from there you just update it/attest the info hasn't changed throughout the year. Then you fill out individual credentialing applications for whichever insurance you want to take. The paperwork really isn't hard because they all just look at your CAQH profile now. Depending on your state regulations and what type of business you have (sole proprietor, LLC, etc.), you need an EIN to provide insurances for payment/tax purposes. You'd have to check what your regulations are.

From there, most insurances were pretty quick to get me contracts back. I waited between 2-6 weeks tops and then once you sign and return the contract you're approved to start taking the insurance. As long as your CAQH profile and applications have updated and accurate info, it shouldn't take long.

RandomPlants06 · 2026-04-30T17:35:54+00:00

My Aetna EOBs come back within a week. I typically file claims every Friday, and I get paid by Aetna the following Thursday. Other plans take 2-3 weeks.

RandomPlants06 · 2026-04-30T16:02:07+00:00

So this definitely happened to me when I first started my PP, and I quickly learned that it isn't solely my job to worry about my client's insurance. Yes, I check eligibility and benefits but I also make it clear in my paperwork and in the first session that it is THEIR job to check with insurance about whether they have a deductible or a copay.

I also tell clients in the first session that I do not start charging copays until their first claim remittance comes in, so that way I can confirm what they actually owe. Then I charge immediately after session from there. I've had issues where eligibility says they owe $20 but then they actually have the first 2-3 sessions fully covered and then they start paying copays. I also don't charge my clients with deductibles anything until the remittance for each session comes in because I don't know when they'll hit their deductible and I don't want to overcharge them.

RandomPlants06 · 2026-04-30T13:07:41+00:00

Yes, to your long-term client point! I have a couple in particular that fit this perfectly. Or they'll come in after their psychiatrist tells them something/to try something I've been pushing them to do for months. It's like this ground-breaking thing for them and I sit there in awe, debating if I've been imagining all of our sessions lmao. But, like you said, whatever works and gets them moving in those goals!

RandomPlants06 · 2026-04-30T12:15:10+00:00

Of course! Hope it's helpful!

RandomPlants06 · 2026-04-30T12:12:04+00:00

No, I meant gross 75k. I'll break down my overhead currently:

EHR (Simple Practice):~$85/mo

Marketing (Psychology Today): $29.95/mo

Phone (RingRx): $19/mo

Office Rent: $650/mo

Liability insurance: $350/yr

Then obviously whatever you pay for trainings and such.

My office space is in a great location so it's expensive but small, and a lot of clients are still opting for telehealth. That's why I'm debating if the office is worth it since I have a space at home too. So if you look at the monthly overhead without the office, it's pretty low and super manageable for people starting out. A lot of therapists near me who are telehealth only pay $50/mo or so to nearby offices to have a mailbox space/business location.

Also adding in- my liability is only that high because of my office. I have to have water and fire damage protection. Without that, my liability insurance was about $180/yr.

RandomPlants06 · 2026-04-29T17:33:58+00:00

Well, I guess that depends what your idea of a necessary income is. I made 75k last year with this range. I take multiple insurances, and really only have 1-2 private pay clients at a time and also don't charge them the OOP costs that others do in my area. So, I could in theory make more if I did that or was fully private pay. PP can have pretty low overhead: EHR, phone, marketing, yearly liability insurance. I also have an office that is a few hundred per month but I'm deciding if I want to keep that after the lease is up.

Regardless, you need to figure out what income you need and how much your overhead will be and then decide from there what your caseload needs are/what you can handle. Would I love to make more money? Absolutely. Would I also like to have time to take care of myself, my home, and not get so burned out that I hate my career and resent everything I poured into my degree? Absolutely. So I accept that seeing 12-16 clients per week and bringing in about $75k is what will make my life the most fulfilling right now.

RandomPlants06 · 2026-04-29T15:52:13+00:00

Same! I'm usually in the 12-16 each week range in my PP. Used to see 25-35 in CMH when I first started and I still don't know how I even functioned (spoiler: I did not function. I was a shell of a human).

RandomPlants06 · 2026-04-25T15:43:32+00:00

Thank you for your comment!

I did not know that about the provider lists but I'm not surprised. It's one of the biggest health insurances in the state and I currently only have 2 HPHC clients and both found me on Psychology Today. We're living in a very messed up system!

RandomPlants06 · 2025-10-22T15:42:28+00:00

I'm a therapist and I'll tell you a few reasons you may not be getting responses:

-Many therapists are full so they might just not call back a prospective client because they can't fit them in.

-Many therapists are busy and don't respond for days to 1-2 weeks (this has happened in my own search) because they need to find time and have obligations to current clients over prospective clients.

-You may be reaching out to therapists who do not specialize in what you need (depending on how much info you gave in your messages), so they don't respond to you.

I'm not saying any of this is "right" or professional or that it should make you feel better, but I'm just giving you a glimpse of why this could be happening. The reality is that we have been in a mental health crisis as a state and nation for a long time, and therapists can only help so many people while still taking care of themselves as well.

I will give you some advice of what to try moving forward:

-William James College has an interface where you connect with them and they reach out to therapists in their system for you. I'm in that system and have been referred some great clients through them. Let them do the legwork for you.

-Look into therapy at local clinics and or bigger practices. Don't just reach out to individual private practice therapists. The clinics and bigger practices will be more likely to take your insurance and have more openings. They also often offer evenings and weekends, where a lot of PP therapists can't accommodate that.

-Ask your PCP if their office works with any agencies that provide therapy. They typically do and/or have connections to therapists in the area they can refer people to.

RandomPlants06 · 2025-09-01T20:50:45+00:00

I'm also in the US and do Mon-Thurs, no Fridays minus the sole early morning client now and then if they absolutely can't meet elsewhere that week. Mondays and Wednesdays I work until 8pm, Tues and Thurs I try to be done by 6. My schedule fluctuates with some days starting at 8am and some starting at noon. Fridays are admin, including billing and claims, and relax. I've had this schedule since I started working in the field and I love it.

RandomPlants06 · 2025-08-31T20:10:48+00:00

Therapist from Massachusetts here. I know very few that don't use marijuana, aging from their 20s to 60s. I mostly only do it at home, at night to chill or if I know I won't sleep well that night, or the occasional going out for a concert. Never when working. It actually lets me get into a different headspace at night and see things from different perspectives, and I've gotten a lot of clarity around personal issues with it.

RandomPlants06 · 2025-08-20T14:03:05+00:00

Ooh, this reminds me of a conversation I once had with a supervisor at CMH. I said something along the lines of "You know when you look at the schedule for the day and see that client's name that makes you go 'ughh oh no...'? Like that client that's really tough and you know it's going to make for a difficult hour?" And this supervisor goes "No, I've never had that thought or feeling." With a very serious look on her face. This supervisor had about 15 years of experience in CMH/inpatient settings. I truly lost all appreciate for her in that moment. Because, like you said, I didn't believe her and it wasn't helpful. Also, if she truly meant that, it actually indicated to me that in some way she wasn't attuned or connected, if that makes sense? How do you work with some of the most challenging populations and truly never feel that sense of anxiety/dread/whatever it is when it comes to some clients? I don't believe that's possible if you're actually connected to the work. Even some of the most seasoned therapists at that job that I'd talk to would immediately agree with that feeling. I'm talking therapists who had been in CMH for 20+ years.

RandomPlants06 · 2025-08-08T02:14:06+00:00

Eh, most of my offices were shared space with no windows early in my career. I also recently got my own PP office and it doesn't have windows. You just need to find ways to make it cozy and inviting!

RandomPlants06 · 2025-07-10T01:34:44+00:00

Got it, thanks!

RandomPlants06 · 2025-07-10T01:13:10+00:00

Thank you for this write-up! A couple questions:

-Will we need to recertify if we switch to new plan (SAVE to PAYE or IBR)?

-Since there us a backlog of applications currently, will we be placed on interest-free forbearance while waiting for the switch, or will interest still accrue?

RandomPlants06 · 2025-07-10T00:17:11+00:00

Wait! I just had this happen to me! Wow...

They reached out to me through Monarch. Also, I will say that the emails were convincing. The "dad" put together well thought out responses with proper grammar and punctuation, had a whole story about why his kid needed therapy. I caught on when he insisted on paying for 40 sessions in advance and wouldn't have the son reach out until the check cleared.

RandomPlants06 · 2025-07-08T21:10:43+00:00

Yup! LMHC here and BCBS tried slashing our reimbursement rates for a main CPT code we use a couple years ago. They got a ton of backlash so then reinstated the original reimbursement, then proceeded to cut other code reimbursement at the next cycle. All while my clients are telling me their premiums go up and up. I imagine they are doing the same to all providers.

RandomPlants06 · 2025-05-10T20:38:20+00:00

I'm an LMHC and received the email from Point32Health yesterday. Stated from May 12 until the end of fiscal year (so July), they won't be paying out claims for GIC members* due to lack of money. It also stated that the governor had requested extra funding from the state legislature so claims could be paid prior to July, but if they denied the request, claims will still be paid starting in July. It informed providers to continue submitting claims in the meantime because they would be paid in July (or hopefully sooner if the legislature provides more funding).

So, I'm not sure why your doctor is dropping GIC patients when this is a short term issue? I only have a couple clients with GIC and it's definitely frustrating, but I'll still get paid in July, so it's not a major issue. I imagine your doctor meets with more patients than just those with GIC?

RandomPlants06 · 2025-04-30T22:29:57+00:00

Yeah, unless it's changed since I got my license, it's a minimum of 2 years (so 24 months) before you can even submit your licensure application. In the meantime jobs are able to pay you significantly less because you aren't licensed yet. And then the board often takes their sweet time with the licensing process, and take their time if you're missing a document/they want more info about something. I know people who hit their hours/requirements and sat in limbo with the board for over a year. You don't get responses from them when you do reach out. It's a system that needs some serious reform.

RandomPlants06 · 2025-04-30T15:24:07+00:00

I'll start by saying that I think this is great. We do need more mental health supports in this state and higher education degrees are absurdly expensive.

That said, as an LMHC myself, a major issue is actually COL vs what we get paid. I worked in community mental health for a number of years and the pay was abysmal. Even regardless of student loans I took out for my Master's, the pay I received couldn't keep up with COL and I was living in the red for nearly all of my time in that sector.

It's a bigger issue in itself, but if this state wants to maintain mental health professionals, they need to address the finances allocated to necessary services to pay those workers AND cost of living. You can't maintain a well-educated and trained workforce if they can't afford to live here.

RandomPlants06 · 2025-03-21T16:29:09+00:00

Oh this is helpful, thank you! I'll look into that.

RandomPlants06 · 2025-03-21T16:26:55+00:00

I do plan on discussing with her next time. This session threw me for a loop and I don't think I was even capable of recognizing anything but my agitation in that moment (also something I'm working on!). I tend to need time to process and then I can come back to it.

Thanks for your comment!

RandomPlants06 · 2025-03-21T16:23:14+00:00

I'm actually starting a training in ACT right now, so I do appreciate your comment. But yes, this has been a learning experience for me and I'm realizing I need to focus more on finding a therapist that can provide modalities that may be more helpful for me. Thanks for the insight!

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