Asking Clients for Payment for Services Rendered

As I continue in my private practice, I am finding it easier to request payment from clients when services are rendered. I remember when I first began as a counselor, all of the billing, payments, and scheduling was done by administrative staff. I also recall when I first began my private practice, I was reluctant to ask for payment. I felt like I was insulting or offending people by asking for payment.

It did not take long for me to lose that “shyness”. I began to see that I needed to make a real living! I began to understand that the services that I offer are just as billable as the services in a medical or legal office. When a person goes to the doctor, he/she expects to pay a fee, whether it is a co-pay or full price. When people retain an attorney, they are expecting to pay for the services. The same goes for other services. From another perspective, I thought about how much time I spent in school. I am just as much of a professional as a doctor or lawyer.

I have come to several other realizations:

·         People are not shy or reluctant to ask for services, whatever they may be

·         People can afford anything they really want (cell phones, gym shoes, name-brand clothing, vacations, entertainment, video games, iPads)

·         There is more motivation and participation in counseling when people pay for it (since people have the expectation that they will gain something in return for payment)

·         Many times clients don’t think of “social services” as something they should pay for (I have actually had a client tell me that he should not have to pay to talk to someone!)

What I have done over the last couple of years is to develop better financial policies. I take time to look at some of the financial policies that other entities have developed for their businesses. Here are some of them:

1.      If there is an authorization code needed for services, please provide this information on or before the initial visit. If not, then the full payment will be due at the time of service.

2.      All payments, deductibles and/or co-pays are due at the time of service.

3.      The patient is responsible for all amounts that are not covered by the insurance plan.

4.      Cancellations must occur at least 24 hours prior to the scheduled appointment, or a ___ fee will be assessed.

5.      Patient must provide a valid credit card that will be billed for late cancellations and no-shows.

6.      A $--.00 fee will be charged for any returned checks.

7.      There are fees assessed for phone consultations, letters, and court appearances.

I also have my website set up in such a way that people can feel secure making payments online. The financial policies are spelled out clearly on my website, and clients read/sign a copy of the policies at the time of the first visit.

So what about the various fees for services? Should I do sliding scale fees for people or not? I see now that my fees need to remain set. Creating a sliding scale is tedious. It means that the rules/policies do not apply equally to everyone. What about people who cannot afford to pay for services? The best option is for them to find someone they can afford. A second option is for me to periodically offer coupons for certain services. A third option is to have a lower cost private pay situation, but interns will actually provide the services under my supervision.

Now, since I do my own billing, I am more cognizant of the financial aspects of my business. I make sure to communicate very clearly with my clients. I believe that it helps when clients can see me as a person, as a small business owner. Most hard-working, responsible people have no problems paying for services.

To conclude, I decided that paying for services is actually a part of the treatment process. It’s about accountability and motivation. As I mentioned before, people are more motivated in counseling if they are paying for the services. That has been my experience.