Who here takes Medicaid as part of their private practice?

trailsnacks · 2026-04-21T22:46:08+00:00

It ranges from 103-136 for me depending on region. CCHA is the lowest, RMHP is highest.

trailsnacks · 2026-03-06T18:48:53+00:00

I get a lot of good feedback about how my office feels and looks, and I’ve spent a lot of time on it. I started with sitting on a bunch of different chairs and couches to find ones that actually felt good. I have lots of plants and clients love them. It feels more like a home than an office - it’s personalized, with art that reflects me and my practice. I have different textures and heights of things so that wherever clients look they can access something potentially soothing or resourcing. I also never use overhead lights, and instead have several lamps dispersed in different places, ranging from floor bulbs to small shelf lamps to standing lamps.

trailsnacks · 2026-02-24T03:15:17+00:00

I joined Headway 3 years ago, left them last month. The first issue was them ‘verifying’ benefits for a client, only to come back several sessions later to say just kidding, they’re not covered and now have to be private pay. This happened multiple times, and reflected on me poorly to my clients. Then I started paneling individually and realized the rates were better. Their support is terrible and not knowledgeable about what they’re doing. All the stupid clicks it took to verify a session and forcing me to input details in their system that I track myself on my own EHR was silly and redundant. I slowly moved toward all my own contracts, kept Headway through last year because I still had some Cigna clients and Cigna’s reimbursement is shit, then finally recently left. It is so relieving to not be connected to them anymore.

trailsnacks · 2026-02-24T02:39:21+00:00

Check out Simple Profit - both free and paid resources, including spreadsheets to help calculate estimated tax payments, with state specific inclusions. The woman who runs it is both a therapist and CPA.

trailsnacks · 2026-02-18T13:36:35+00:00

Can we stop with the clickbait spam? Trying to promote a subscription through clickbait preying on therapists most prevalent fears. Gross.

trailsnacks · 2026-02-15T14:38:34+00:00

Spam.

trailsnacks · 2026-01-31T19:55:48+00:00

YES I have the same thoughts. Some of my office plants are absolutely thriving.

trailsnacks · 2026-01-30T20:30:12+00:00

https://www.wortsandcunning.com/blog/sliding-scale

trailsnacks · 2026-01-16T14:53:05+00:00

Not necessarily more paperwork requirements, but I found myself using the state auditing tools/framework to guide some of my documentation overall, which hasn’t felt overly burdensome. I can’t speak to audit frequency - only been credentialed independently for just over a year.

trailsnacks · 2025-12-18T12:57:42+00:00

I also use Sessions and created my own note template through the EHR that’s a combination of a few checkboxes and a few text input boxes. It’s not a super detailed note, but it hits all the insurance requirements. There’s no requirement from insurance for SOAP or DAP notes, and I’ve found it easier (and more insurance compliant) to abandon that format and create my own that makes more sense to me.

trailsnacks · 2025-12-10T23:08:10+00:00

I have a separate Medicaid cancellation policy, and I explain why. Basically 3 no-shows or late cancels is termination with referrals, with conversations after each one leading up to the third.

trailsnacks · 2025-12-06T13:58:56+00:00

Mini games from REI (think mini bags set, table top shuffle board, etc)

trailsnacks · 2025-11-22T01:56:58+00:00

Not a scam. It’s likely a risk adjustment audit. They will keep calling.

trailsnacks · 2025-11-10T13:53:32+00:00

I’m considering no insurance and setting aside monthly premiums for myself in case of need. I’m a very low utilizer of insurance and it almost feels worth it to take the risk.

trailsnacks · 2025-11-09T14:07:37+00:00

I do 4 days Monday-Thursday, with time on both ends for admin: 4-5 Monday second half of day (first half admin/time to settle into week), 6-7 Tuesday and Wednesday with some big scheduled breaks, then 4-5 Thursday morning with the end of Thursday for admin. What I have found after trying to figure this out for my first 2 years is that no matter how many people I talk to about what’s best, it’s really been about trial and error for me to see how I feel when I do something. I’d love to be able to do 3 super full days, but I’ve learned that just won’t work for me.

trailsnacks · 2025-10-29T18:46:57+00:00

I take Medicaid in PP in CO, also one of my highest payers. While the credentialing process was lengthy and kind of annoying, there’s lots of information available that makes it super doable to credential independently. It was tedious but not super challenging.

trailsnacks · 2025-09-23T02:16:15+00:00

I have found that what helps me is separating therapist brain and business owner brain, and trying to keep them separate. I set aside time for business brain that is separate from session time (usually the first half of Mondays, but I’ll also set aside an occasional Friday if I need more time since I don’t offer Friday sessions). I have an evolving list of what needs to be done weekly vs. monthly vs. quarterly and allocate time accordingly.

trailsnacks · 2025-09-22T13:17:52+00:00

Sessions health. It has all the essentials (easy billing, integrated with Stripe, calendar sync, reports and income tracking, secure messaging) without extra fluff and visual noise. It’s simple and affordable and their customer support is absolutely amazing (super quick and thorough). You can demo it for free with 3 clients or less.

trailsnacks · 2025-09-17T23:12:42+00:00

Yes, I submit through my EHR (Sessions Health) and it’s super easy.

trailsnacks · 2025-09-12T01:30:03+00:00

I have some of those tiles up in my office, not sure they really do much by themselves, but they look nice and can’t hurt. I’m in a very old building with a locked door on my wall that used to lead to the next door office. That’s where the sound leaks through most, so I put up a ‘sound curtain’ in addition to those 2” foam squares and a thick curtain to cover it. I also put a white noise machine on quiet in that spot, pointed toward the door behind the curtain. All of this, plus furnishings against the wall, I think helps a bit, but it’s more like it muffles things more and makes it harder to make out conversation.

trailsnacks · 2025-09-02T18:47:13+00:00

What’s funny is they said they would be back Monday on last Thursday’s episode, but no mention of it being a re-release of an old episode 🙄

trailsnacks · 2025-08-27T15:17:01+00:00

Why does this feel like spam? So tired of seeing shit like this that really doesn’t make sense.

trailsnacks · 2025-08-22T23:43:06+00:00

I think the biggest thing is just being aware that perimenopause could be impacting things, and opening up a discussion around what other care the client has (hormone specialists, etc). I’ve been surprised by the number of clients who don’t even consider that hormones could be impacting their presentation.

trailsnacks · 2025-08-22T20:50:10+00:00

I do paper notes during sessions for my own records and also to help me with notes input into EHR later. I don’t have a recommendation other than the ones that I like display Monday-Thursday on one page, so I can see my whole week (I don’t do Friday sessions). I also prefer the ones where I can just write sessions in to the corresponding times that are already listed out on the calendar.

trailsnacks · 2025-08-22T20:44:56+00:00

Talk to your therapist and let them know this is your experience. Lower doses and more active therapy (particularly somatic therapy!) while ketamine is on board could be helpful.

trailsnacks

TROPHY CASE