Exciting News! The 14 Concrete (but not so hard!) Steps to Private Practice resource guide is now available exclusively on Amazon!

Yep, I did it.

The guide I wrote to help others start their private practice (and to keep track of pages and pages of information for myself) is now right there on Amazon as an e-book! Just call me Bonnie McKeegan, Indie Author! Woohoo!

For a limited time, the guide is FREE with your Kindle Unlimited Subscription. To purchase, it’s competitively priced at only $2.99!

This eBook is a comprehensive “how to” resource manual to help you get started. If you are struggling, check out the Table of Contents by clicking View in the book display below. If you are unsure if this book addresses your questions, feel free to Contact me.

The 14 Concrete (but not so hard!) Steps to Private Practice: Plus, Six More Steps to Consider – A Guide for Licensed Clinical Social Workers and Licensed Marriage Family Therapists.

This is the stuff they didn’t teach us in grad school about private practice!

Amazon ebooks for Kindle Can be Read Everywhere

Don’t own a Kindle? No problem! From Amazon Download the free Kindle app and start reading Kindle books instantly on your smartphone, tablet, or computer – no Kindle device requiredLearn more Read instantly on your browser with Kindle for Web.

Get your copy, share my news with your LCSW, LMFT, and LPCC colleagues.

Leave an honest Amazon Star Rating and Review so others can find and decide if this resource is for them. Thank you!

If you’ve already read the guide or used some part of it for your private practice, would you be so kind as to hop on over to Amazon and leave a review? Even a few stars without any words would be extremely helpful. I know you are busy, so brevity is perfectly okay. Reviews are the drivers of the mysterious algorithms of Amazon. Please help my book get noticed!

I am so excited to announce the availability of the guide as an e-book now.

What Next for the Guide?

The next step may be to offer it as a print book. But, I gotta be honest, the many many links to resources included in the e-book are priceless. While a print book has definite positives, having it in your hands will require you to manually search for the resources referenced throughout the book. A print version will also cost substantially more due to the estimated page length. As a PDF it is a hefty 178 pages!

Help me get 150 reviews by leaving your own and sharing the book’s Amazon link with colleagues. Even your own therapist might benefit from this jam-packed resource guide ;-). I get calls from established therapists who end up benefiting from the information in this eBook.

Here it is! TaDa!

Feel free to contact me with any questions or suggestions. I love hearing from readers.

p.s. In case you are wondering, e-books on Amazon can be: Read anytime in your browser, or on your Kindle apps and devices.

Rock on my friends out there healing the world one person, family, and community at a time.

More about Bonnie Amazon Author Page

3 Marketing Tips with Content Suggestions for a Better Therapy Practice Website

Designing your private practice website requires thoughtfulness.

What is the purpose of your website? What information and content should you include?

The design, theme, layout, and management may be outside your wheelhouse and you might hire someone to do it, but you still need to decide on the content to put on those cyber pages.

You’ll need to tell your designer what you want potential clients to see when they land in your tiny space on the internet.

What impression do you want a prospective client to get when they land there? How do you want them to feel when they are looking at your website pages? The answer is easy: You want them to feel your authentic compassion and concern for their well-being.

I’m not talking about the colors, pictures, or design.

I’m talking about content.

What is excellent content for your psychotherapy practice website?

Well, that depends.

Are you focused solely on telling your visitors about your services? Creating a cyberspace that is all about you and what you offer? If you are, that’s okay. Most of us do it that way.

We think: What am I offering clients? Who am I as a therapist? What will they get out of coming to see me? What services do I offer? Fees, policies, insurance accepted, etc. These are some of the obvious things to put on your website: the business side of things.

Or, are you thinking about the other things people are looking for besides a compassionate therapist?

Tip #1 Your website should contain content that is more than just all about you. It should be more than an advertisement.

People are looking for help. They are looking for resources. They may not be ready for therapy, but they are seeking some kind of relief or information.

Think about the types of resources your prospective clients might need. If you’ve created something broader than “all about me and my services,” then a prospective client may find you because they are looking for some other resource. Information or resources for depression or anxiety, for example.

A great example of helpful content is the Beautiful Minds Mental Health Clinic website in Auburn, California. They have a page with several anonymous mental health screenings for website visitors to fill out (PHQ, GAD, PTSD, bipolar, alcohol use, drug abuse). https://beautifulmindsmedical.com/for-patients/patient-forms/patient-health-questionnaire-phq-9/

If visitors find helpful information on your site, they might remember you when the time comes; when they are ready to talk to someone.

When I designed my website. I had one main goal: Help people find help, whether it was my services or not.

Tip # 2 Adding value to your website visitor’s experience shows you care about them, not just about gaining a new client.

Here are three pages that add value to your visitor’s experience. The following links are to my LCSW website which used to house only private practice information. Feel free to copy anything from these pages you find useful:

The Help Finding a Therapist page was particularly handy when I had a full practice. I referenced it on my outgoing “practice full” voicemail message. People thanked me.

Pages like these add value. They tell visitors you are thinking about their needs not just advertising your services. Once you have them set up, an occasional update is all that’s needed.

Tip #3 A professional website has all the requirements for your licensing board regulations and is ADA-compliant.

Check with your legal / liability advisors for risk management advice. Every licensing board and state has regulations regarding advertising.

For example, in California these are two of the licensing board requirements:

  • CA Board of Behavioral Sciences (BBS) Complaint Notice must be posted on your website. CA State Disclaimer: The California Board of Behavioral Sciences is the licensing entity for Social Workers in California. You may file a complaint by contacting: Board of Behavioral Sciences 1625 North Market Blvd., Suite S200, Sacramento, CA 95834 Telephone: (916) 574-7830 http://www.bbs.ca.gov
  • CA BBS: Your Clinical License number must be easy to distinguish. California licensees and registrants must include all of the following information in any advertisement (https://www.bbs.ca.gov/pdf/publications/adv_guide.pdf – see PDF for examples):
    • Your full name, as filed with the Board; and
    • Your license or registration number; and
    • Your complete title or an abbreviation deemed acceptable by the Board.

Here are two nationwide examples to think about:

Designing your website is a creative process. Get help if you need it, but stay in tune with what’s on your website. Spruce it up periodically.

Remember: Keep an eye out for changing regulations.

Who designed your website? Leave a comment with a link to your website and let us know who you recommend.

Nothing in this post or on this website constitutes legal or clinical advice.

If you’ve found this information useful, consider subscribing to receive blog posts and the monthly Navigator News Newsletter.

Are you an LCSW, LMFT, or LPCC new to private practice? Struggling? Check out my book over on Amazon.

The 14 Concrete (but not so hard!) Steps to Private Practice: Plus, Six More Steps to Consider – A Guide for Licensed Clinical Social Workers and Licensed Marriage Family Therapists https://a.co/d/38sa2vE.

Private Psychotherapy Practice closed & eBook Published on Amazon!

(post edited 2/4/23)

I wish to extend my gratitude to everyone who has supported my consulting practice and blog these past few years. You were my inspiration for developing my consulting business.

Housekeeping: If you are a prior therapy client needing to reach me, Contact Bonnie here.

Along the path of my consulting practice, I’ve met some incredibly amazing clinicians, some of whom I am honored to call friends. Thank you all for sharing your unique wisdom with me so that I could learn, and in turn, pay it forward!

My private practice and consulting businesses have yielded some of the most fulfilling work experiences in all of my years as a social worker. I loved my therapist chair from beginning to end. I continue to enjoy this mentor chair from which I type this moment.

As 2022 comes to a close, so goes my private practice business. And, I’ve cut my consulting business back to offering brief consultations only.

Life brings changes in waves of turbulence. The most recent wave in my life requires my full attention. In order to fly through it without getting too banged up in the roughness of it, earlier this year I made the difficult decision to close my practice and consulting businesses (reopened in February for limited services).

eBook now on Amazon!

The private practice start-up guide that many clinicians inspired and have come to know me for is now available exclusively on Amazon! It’s FREE for everyone through Sunday, February 5th, 2023. It’ll continue to be FREE to borrow in the Amazon Kindle Unlimited Subscription program through April 30th, 2023.

After February 5th, 2023, this amazing resource (can’t believe I ate wrote the whole thing), will be priced competitively.

It’s not about the money, after all. However, unlike popular ideas about the profession, I came to social work with expectations to earn a decent income. My goals were achievable, but it wasn’t always easy. In fact, some settings I worked in became downright miserable.

More about that someday… As a writer and consultant? I don’t have monetary goals. It’s more about the journey (but a little to cover the cost of websites and clinical memberships is always a good thing).

Are you wondering how my book is being received? I was too, so I checked all day long for six days straight after publication (nope, not obsessed with stats, sheesh).

After achieving #1 Best Sellers Ranking in Private Practice Management and #1 in Psychology Reference on Day 2 of publication, it remained there for days on end! The followiing is from February 4th, 2023. My book has achieved its own life force!

For Now – What’s Next?

For Me (but you are as important!):

I write. I provide brief consulting services. I take care of my family. I have a new role in my life, about which there are no words I can write publically at the moment. Regarding the personal things I can write about (and this may be unethical as a blogger, but, hey, you can skip it, right?), I also write occasionally over on my personal blog Healing through Writing & Creativity. That’s where my “writing” gig began in 2017. I practiced on readers over there. It’s been wonderful.

For You:

Most importantly: Keep your head above water. Float when you need to.

Keep up your good work providing services to those who need them!

For Me and You:

Get your copy of my new ebook to have all the resources you didn’t know you needed to know about for your private practice at your fingertips, forever. Then, if you feel so inclined, bless my book with a review. Star Ratings and Reviews help the mysterious Amazon algorithms notice so that others can find it.

eBooks are e-co-friendly!

Amazon Author Page

Blah, Blah, Blah (as my mother would say)

It has been a wonderful experience running my private practice since the fall of 2014 and then adding the consulting aspect as my practice grew. If you’d told me at the beginning that others would seek out my help because of my success, I wouldn’t have believed you. In case you didn’t know, it started out as an experiment: Can I do this thing called private practice?

That just goes to show how ya never know what’s going to happen when you embark on a new adventure.

Keep up the good work, everyone, and fly above the clouds every chance you get!

Ya never know what amazing adventures life will offer you, but in my experience, they don’t always present as a shiny attractive “yeehaw let’s do this” type of thing. Often they begin as an overwhelming wave of not-so-fun stuff.

Wishing you all health, peace, and grand adventure in 2023.

p.s. If you have any desire to follow my other passions, please visit my writing space at www.bonniemckeeganauthor.wordpress.com

Does Medicare require a real brick-n-mortar office for your private psychotherapy practice address?

Does Medicare require you to have a physical office to see clients in your private psychotherapy practice?

I’ve seen this question posted several times in forums since the pandemic began. I get asked this question often, so here’s the long and short of it.

Short answer first: YES. CMS (https://www.cms.gov/Regulations-and-Guidance/Regulations-and-Guidance?redirect=/home/regsguidance.asp) makes the rules and regulations and they apply nationwide.

Here’s the long answer I recently wrote to someone (I’ve edited that response and added some minor details and links for this post):

Yes, and…

Regular Medicare requires us to have a brick-n-mortar practice address/office that is not your home address. You have to be able to see Medicare recipients in person and your home is not acceptable (and after the PHE ends, you will be required to see them in person periodically; how often will depend on how the rules change by then). These are CMS rules and regulations that apply nationwide. 

Your billing, correspondence, and notification addresses can be your home address.

If you decide not to get a real office in your telehealth-only practice and you decide to see Medicare recipients who can pay privately (no reimbursement from Medicare), you will need to “opt-out” of Medicare. With your license (LCSW), you are already an “eligible provider,” even if you have not “enrolled,” therefore, you are required to follow Medicare guidelines for Medicare recipients, unless you officially “opt-out.”  (https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/Manage-Your-Enrollment)

By the way, for seeing Medicare folks, following the guidelines includes charging only what Medicare will reimburse (and that is dependent on which jurisdiction you are in). (https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Downloads/contact_list.pdf)

The question I received recently also indicated the clinician might apply to commercial insurance panels. Here’s information related to that and Medicare:

Some commercial insurance companies require you to have a brick-n-mortar office, but it might be hard to figure out if the panel you are applying to requires it. 

I would call provider relations and ask before going through the hassle and/or cost of credentialing (but know that information from them can be inaccurate and also remember they can and do change their rules even after you are contracted). 

That commercial insurance you are interested in may even have a Medicare product, so without a brick-n-mortar, you’d either a) be excluded from their Medicare folks, or b) to be eligible to see their Medicare recipients,  you’d have to enroll with regular Medicare first.

More information:

I enrolled in Medicare and contracted with several insurance companies from the start of my practice, then this year took myself off all commercial panels.  

Medicare has been my bread-n-butter since the beginning (and my favorite population), however, if I ever reopen my practice (closed this summer due to family caregiving), I will opt-out of Medicare (much to my own surprise) because the risks have become personally unacceptable.  It is a personal and business model decision you should make with as much information as possible.

The person who asked me recently didn’t ask about private pay only, but here’s a tip:

You can make more money hourly with private pay only (don’t offer superbills for clients to get reimbursed). You can avoid the risk of audits and clawbacks which are very real, have less stress about several everyday things related to insurance contracts, reimbursement and documentation requirements, and have greater peace of mind in the short and long runs by offering private pay only (no insurance reimbursement to you or client).

You just have to understand how to find clients.

Offering “telehealth only” makes this doable since you can see clients across the state you are licensed in (and potentially more states with laws and regulations changing due to pandemic demands) making it a more open field to build a referral network for clients who can afford private pay. The biggest concerns are the clinical implications which I’ve written about in a recent thread on the NASW forum.

For anyone with questions, I’m happy to consult further regarding the pros and cons of insurance contracting and enrolling in Medicare. The cost is $90/hr whether it’s online video, phone, or detailed email responses after we’ve had the first consultation.

If you are looking to start your private psychotherapy practice, check out the guide I wrote. It’s guaranteed to answer a zillion questions (okay, not a zillion but lots).

Get the guide on Amazon:

Recommended Reading: Recovering the Self A Journal of Hope and Healing

Sometimes leaving your dream job is your best chance for recovering from Post-Traumatic Stress Disorder (PTSD) triggered by vicarious trauma (VT). Leaving the job that continues to trigger your symptoms can create a healthy opening for finding your way back to your sense of meaning, purpose, and an even truer self, a better version of the identity that was shattered.

Leaving that job does not mean you are a failure. I know this to be true because I lived through the harrowing experience of my brain being hijacked by PTSD and coming out the other side whole again.

An article I wrote The Turbulence of Vicarious Trauma Propels Success about my experience with PTSD triggered by the trauma of others was recently published in Recovering the Self: A Journal of Hope and Healing. If you are a clinician or know someone who is at risk for vicarious trauma, I invite you to read my article in the journal.

The Turbulence of Vicarious Trauma Propels Success: The Overview (get the journal for the entire article)

In 2011, I was working at my dream job in a Level II Trauma Center as an on-call social worker. I experienced PTSD as a result of witnessing a family’s particularly tragic death of their child on a parental holiday. Some professionals call this Vicarious Trauma (VT) or Secondary Traumatic Stress (STS), but my doctor called it PTSD. My brain didn’t know the difference; it reacted as if it were my child that died. I took a five-week break, then went back to work. Although the intensity had decreased enough to return to work, I was still suffering from symptoms. I feared someone would decide I couldn’t do my job anymore. I wrestled with big questions: Who was I to suffer so much when it wasn’t my child that died? Why am I so weak when everyone around me is dealing with so much tragedy and they appear normal?

Two years later, I quit that dream job amidst confusing feelings of guilt, shame, fear, and beliefs that I was a failure for having experienced PTSD; I still felt like an imposter posing as a social worker. My social worker identity was still deeply wounded even though I’d successfully navigated the halls of the hospital for two years after the incident.

I was not happy at my job anymore. I didn’t feel “safe” in an environment that didn’t support social workers experiencing vicarious trauma. So when a new opportunity arose at a local hospice, I quit my dream job. During that time, I was plagued with more questions: Was I fleeing as a result of PTSD? And, if so, what did that say about me?

It took years of tears, and a lot of writing, talking, and “doing” to work through my questions and regain my confidence as a social worker. My successful private practice was an integral part of the process.

Publication = Validation

In December 2017, when my mom was dying of breast cancer, I wrote an article about my PTSD experience and submitted it to the editor of Recovering the Self: A Journal of Hope and Healing. My article titled The Turbulence of Vicarious Trauma Propels Success was not only accepted but was set as the featured article in Vol. VII, No. 1 Focus on Work.

What a happy shock that was! I was only in my first year of creative writing publically over on my Healing through Writing and Creativity blog. I was writing to heal various wounds, not just from my hospital experience.

Four years after submission, the journal was published in April 2022. The truth of what happened is now “public.” It’s out in the world in a permanent space where critics and judgment abound. I invite you to read it.

This edition of the journal is offered as an e-Book only, so it’s reasonably priced at $4.95.

There are 26 articles, some are poetry, containing stories of challenges and recovery related to work life. Many of the articles are written by published authors and poets who are doctors, therapists, and other clinicians.

I am honored to be among them as an unpublished (#futureauthor) writer! UPDATE Feb 2023: Published Author of The 14 Concrete (but not so hard!) Steps to Private Practice: Plus, Six More Steps to Consider – A Guide for Licensed Clinical Social Workers and Licensed Marriage Family Therapists.

In Recovering the Self: A Journal of Hope and Healing, I guarantee you will find inspirational and courageous stories of recovery.

The Timing of Things – Closing My Private Practice

It is both ironic and serendipitous that the article I wrote about finding a better version of my social worker identity through starting my private psychotherapy practice was published during this time when I am closing that private practice for an undetermined period of time. Private practice has been the Best. Job. Ever., however, life has brought new turbulence (unrelated to but tagging onto the effects of the pandemic) coinciding with a strong desire to explore other meaningful avenues in life.

I no longer have the office described in the article (thank you pandemic for that most unwelcome turbulence!), though the furniture, art, and spirit of the office reside throughout my home.

I hope to someday get back to the goal of making another career dream come true: a book-length memoir about being a social worker whose career has continually been propelled by death, loss, codependency, and other difficult realities of life.

For those here for my coaching, consulting, and mentoring help, I will continue consulting with clinicians starting or struggling with aspects of private practice. The foundation of our work together comes from The 14 Concrete (but not so hard!) Steps to Private Practice: Plus, Six More Steps to Consider – A Guide for Licensed Clinical Social Workers and Licensed Marriage Family Therapists.

Feel free to contact me with your questions.

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Photo credit: Journal eBook cover edited by Lisa Redfern at Redfern.biz

Telehealth Video-Conferencing Platform Choices for Psychotherapists

As I spent time editing and updating the Telehealth chapter in the newest version of the guide, which by the way is now called 14 Concrete (but not so hard!) Steps to Private Practice, I realized there are so many more choices for telehealth video conferencing than there were just two years ago. No doubt the pandemic sparked big growth in the market.

If you are looking for telehealth online video options for your psychotherapy practice, check out the list below.

When making your decision, of course, you’ll consider cost, but you should also think about ease of use (does the client need an app or can they access from any device without an app?) and any systems like Microsoft Teams or Google Workspace that you can use for multiple purposes in your practice and that happen to include video-conferencing.

And don’t forget to choose a service that offers the Business Associate Agreement (BAA) that brings the service into HIPAA compliance. When you choose a platform, you might have to complete a few extra steps in order to get that BAA in place.

Telehealth-specific online video platforms that offer that crucial Business Associate Agreement (BAA):

I use these two platforms:

  • Doxy.me – https://doxy.me/ The free version includes the BAA. With a paid version you can modify your Waiting Room and have additional features like group participants and screenshare. You can see my waiting room here: www.doxy.me/bonniemckeeganlcsw One advantage of doxy.me is your waiting room URL (the link to see you) is always the same. Your clients can access it from anywhere without needing to click an appointment-specific link like with an EHR platform or another platform where a meeting is “scheduled” (like on Google Meet or Zoom).
  • Google Meet with Google Workspace Plan https://meet.google.com/ For $6/mo you get a whole ‘lotta goods along with that BAA. I recently upgraded to the $12/mo version of Google Workspace for more storage cuz hey, it’s a great place for my gazzillion photos and now I have the option of recording meetings. It also includes tons of other services I love to use (Google Drive, Spreadsheets, Forms, Docs, Calendar, etc.). Google Meet works nicely for group therapy or sessions with family members in different places.

Here’s the list of other options I’ve found:

Several on the list are through Electronic Health Record (EHR) platforms.

If you are thinking of starting an EHR (or switching) and looking for one that offers a telehealth platform, check out my blog post about Simple Practice. Get a discount for your first paid month ($100 if you start in November 2021 / $50 normally). If you use my link, I get the same credit you get.

I used Simple Practice’s telehealth option for a while. It worked for most clients, but two complications occurred:

1) It required an app on the client’s phone and two clients couldn’t add anything to their phones. I got tired of keeping track of who could use the Simple Practice appointment link and who needed to use my www.doxy.me/bonniemckeeganlcsw Waiting Room.

2) Like other EHRs, when you use the Simple Practice telehealth platform, you create a unique appointment link. The client is set up in the system as part of your Video Office. The system pulls that information onto the claim and labels the Place of Service (POS) as Telehealth (02). This is usually fine for commercial insurance companies who want you to use POS 02. However, most of my clients are Medicare (different POS requirements than commercial insurance) so I’d have to manually fix the claim (change the Place of Service to Office – 11) before submitting claims.

So, in the interest of saving time, avoiding confusion, and submitting accurate claims without an extra step (cuz efficiency gives me more time to take a bazillion more photos), I switched all of my clients over to Doxy.me. And as a bonus, this solution saved me the $10 per month fee for telehealth within Simple Practice.

With all of the options available, there really is no reason to use a video platform that does not offer the Business Associate Agreement (BAA) (which makes your use of online video for your psychotherapy clients HIPAA compliant).

This decision can be overwhelming. After trying different options, I have found what works best for my practice.

If you need help figuring out your best option, feel free to contact me.

If you feel inclined, drop a line in the comments and let us know your favorite telehealth platform. I am sure there are more out there I haven’t discovered yet!

Image by Alexandra_Koch from Pixabay

Simple Practice EHR Pros and Cons – link for discount code

In this blog post, I share my experience with the Simple Practice Electronic Health Record (EHR).

Disclaimer: If you want the discount, you MUST begin your initial free subscription by using the Referral Code Link. Start your free first month of Simple Practice here and receive a credit for your first paid month with my referral discount code. – I get the same credit you get and it changes periodically. In February of 2023, the credit was $150.

December 2022: There have been several improvements to the Simple Practice EHR since I last updated this post in detail in early 2022. Because I closed my private practice recently, I may not be writing in much detail about any of these improvements in the future, but here are a few of this year’s updates in the system:

  • Advanced calendar features
  • Client Portal Mobile App for iOS
  • Easier Good Faith Estimates
  • Updated billing features including the much-needed partial payment option
  • Improved interactive whiteboard during telehealth sessions
  • Billers and schedulers can send secure messages
  • Load last note includes a list of all previous notes
  • Create your own To Do list
  • Updated insurance payors page

The referral discount amount changes periodically. However, it’s consistently been $100 and increased to $150 during the 2022 Year-end promotion. The discount is credited to you when your monthly paid subscription begins (after your initial free 30 days). If you find this review helpful and are interested in trying it out, use my referral link. And follow my blog for other helpful information about private practice.

If you are on the fence about trading in pen and paper for an EHR, you should check out my eBook The 14 Concrete (but not so hard!) Steps to Private Practice: Plus, Six More Steps to Consider – A Guide for Licensed Clinical Social Workers and Licensed Marriage Family Therapists. Step Thirteen – Choose Your Charting Method EHR vs Paper is a comprehensive discussion about the pros and cons and offers links to additional articles to read to help you decide what’s best for you.

I’ve been using Simple Practice EHR for documentation and billing since October 2019. Although I closed my psychotherapy practice in fall of 2022, I continue to use the Essential Plan for my consulting business.

I’ve found my way through some of the non-intuitive processes, which can be annoying at times, and overall I still appreciate what this platform has to offer.

In order to fully benefit from any EHR, I always recommend watching all of the training videos and taking all of the classes offered. Here’s a link to the Simple Practice list of classes: https://support.simplepractice.com/hc/en-us/articles/360058349331

I highly recommend using an EHR over paper charts. Why stress out over not being caught up with notes or the quality of your notes when you can get it done more efficiently for less than (or equal to) the cost of one client session per month?

With integrated billing and doing it myself, my expense for billing went from 9% of paid claims to .25cents per claim submitted using Simple Practice (billing fees may have changed so you’ll need to compare based on current claim fees).

To give some perspective, here’s some math for you:

  • 25 sessions x $90 paid per claim: expense to a billing agency at 9% = $202.50
  • 25 sessions x .25¢ per claim: expense to Simple Practice = $6.25

Using an EHR is quite possibly (it is!) the best investment I’ve made in private practice.

What is your charting process? If you are using an EHR, which one are you using? Do you recommend it?

Simple Practice Review originally published October 2020 (edited 2022)

I highly recommend simplifying your private practice by using an EHR as soon as you can afford it. You almost can’t afford NOT to.

For the cost of perhaps one session’s reimbursement per month (depending on your fees), you can present your practice to clients professionally with an EHR Client Portal with all of its benefits including e-signature forms, signatures on treatment plans and other documents, and streamline your practice management to save significant time, money, and stress.

If you have a telehealth practice (like I do), an electronic health record (EHR) with e-signature and a truly “paperless” office is the only practical way to go. Don’t worry, you can still use paper for those clients without access or skills to access the internet and their Client Portal.

During the coronavirus pandemic, using the Simple Practice EHR with e-signature for clients to complete documents made it possible for me to quickly adapt to telehealth only. I didn’t miss a beat in terms of appointments and scheduling new clients when the shelter-in-place directives came down in California in March 2020.

My experience with Simple Practice comes from using it as a solo practitioner since the Fall 2019, so I can’t speak to its benefits or downfalls for a group practice (the cost may be the biggest factor to consider).  It served me well in the office pre-pandemic and continued to be excellent for my telehealth practice. Despite some non-intuitive workflows and idiosyncrasies that take time to figure out (and honestly are kinda annoying), I still recommend Simple Practice. 

My Other EHR Experience

Previous to Simple Practice, I used TherapyAppointment.com (TA) the Legacy system for charting and electronic claims submission integrated with Office Ally (OA). 

Switching to Simple Practice was a vast improvement over TA’s Legacy system in terms of charting, telehealth practice in general, and electronic submission to secondary insurances (which was not possible at the time I left TA.com). 

When I left TA, I had been waiting for over a year for the transition to the new TA 2.0. which would have been comparable to Simple Practice’s platform at the time. I got tired of waiting and I am so glad I made the transition to SP before the coronavirus pandemic turned everything upside down. 

Regarding Office Ally (OA). If you are looking for a billing-only option (using paper charts), check out OA. If I were to drop the use of an EHR (unlikely!), I’d go back to OA for billing. When I took over my billing to save money and serious aggravation but was still using paper charts, I used OA and I still recommend them.

I highly recommend using an EHR for time management (high on my list of priorities) and efficiency/accuracy of charting (also high on my priority list because, uuuuhhhhhmmmm, no, I do not want to give an insurance company any money back for insufficient documentation).  In addition, the ease of integrated electronic claim submission and client billing is a big time saver. Did I mention the money saved doing my own billing?  If you missed that paragraph, scroll up a bit.

Start your free first month of Simple Practice here and receive the current credit amount for your first paid month with my discount coupon code

Simple Practice Pros and Cons

This list is not exhaustive of all the pros and cons of Simple Practice. Some clinicians I know, really don’t like Simple Practice. Others love it or have decided it’s the best they can find, so far, but aren’t very enamored with it. Changing EHRs is an exercise in mental patience and takes mega time, so be sure to look at reviews of other EHRs, then decide how you want to proceed.

These are a few notes, in no particular order, from my experience. I haven’t used all of the features, and in early 2022 the plans changed, so please look carefully at the package you choose.



  • The Simple Practice Client Portal is great for getting documents electronically signed by clients, sharing .pdfs and pictures (to and from clients), secure text messaging with clients, sending invoices superbills and statements to clients, and receiving payments from clients (Stripe is integrated for online payments – the fee is comparable to Square).
  • When a client shares an uploaded document with you or completes the documents you have sent to them, you get an email notification.
  • Clients can “sign” their name now rather than just click the e-signature box.
  • Clients can see their scheduled appointments, documents, and payments in the portal.


  • Regarding creating the documents you send to clients for review, e-signature, and filling out, there are two distinct processes you must learn. Learning the difference between the two and which forms are under each heading takes time. It’s not 100% intuitive.
  • Secure Messaging via the Client Portal can be inconvenient for the client to manage. The direct secure link is sent to the client by email when a clinician sends a message to the client. The link is time limited. If the time expires, the client has to figure out how to get into their client portal.  The system has been improved, but it is still a learning curve for the client.
  • There’s no client-facing app for their smartphone.  For the most part, my clients don’t use the secure messaging feature. It’s too inconvenient because it requires them to sign into the portal. If it was an app on their phone some of them would probably use it.



  • The schedule is relatively easy to manage and you can change the view to day, week, or month. 
  • There is an option to allow clients to request appointments online via a booking widget. (I don’t use this so I can’t report on it)
  • You can create multiple offices (such as for in-office visits, home visits, telehealth, etc). You assign the proper office to each individual client so the Place of Service (10, 02, 11, etc) prepopulates on the calendar (then on the claim form).
  • You can change the office for each individual appointment on the calendar. So, if you usually see someone in the office (and have assigned this to their file), but you change to a telehealth appointment for that day, then you can easily change the Place of Service on the calendar just for that day.
  • You can schedule Repeat appointments (multiple repeating appointments like weekly or every 2 weeks) for a set period of time.
  • You can sync the calendar with your Google calendar (and possibly other calendars) but this service is now only included in the most expensive plan (the Plus Plan at $99 per month). (I don’t use this so I can’t report on it)


  • The appointments on the calendar are not easy to identify in terms of which office the client is scheduled for (in-office vs home visit or telehealth, etc). There is a color coding line on the edge of each appointment on the schedule but it is difficult to see (this may have been improved since this review was updated). This means you need to memorize the color for each office type or open each appointment to see where the appointment is scheduled for. 
  • If you assign the Simple Practice Telehealth Office (for a secure appointment-specific link to the video platform) to your client or to a specific appointment on the calendar, it automatically assigns the Place Of Service (it was originally 02 but may have changed to 10 as of January 1st, 2022) to claims. There is an icon indicating a video camera which is pretty much the only obvious office assignment.
    • Here’s the catch: The automatic Place of Service with the Simple Practice Telehealth Office can be a problem. If you assign SP’s Telehealth Office so that you can use SP’s video platform, but the client’s insurance requires a different POS for telehealth, (e.g., Medicare is different and remains 11 until at least March 2022), then you have to change the POS on each individual claim (too easily forgotten prior to submission and requires extra time/effort).



  • There is a large library of documents, assessments, progress notes, informed consents, etc., that are customizable (with Essential Plan) and/or you can start with a clean slate and create new documents from your own existing documents.
  • Looking up diagnosis codes is straightforward.
  • The Treatment Plan has been updated to make it easier to use (relatively speaking), including getting a signature from the client.
  • Treatment plan reminders give you a head’s up according to the schedule you preset.


  • There are two processes to learn when it comes to creating documents (this is part of the non-intuitive flow I mentioned earlier).
  • Wiley Treatment Planner is now an extra $15 per month, if you chose the Essential Plan (as of the March 2022 change in plans). 😦 Big downer because integrated Wiley makes it so much easier to create a comprehensive treatment plan without having to type everything from scratch (you still have to modify). It might be worth the $15 per month, but with insurance requiring more personalized treatment plans, that $15 month might not be worth it.
  • After you Sign the plan it is locked. You can’t edit it without unlocking it.
  • At the time of writing this review, there was no built-in process for updating the plan properly (in particular, adding progress for each intervention, objective, and goal). You have to unlock the signed plan and edit each line item, which is labor-intensive and not intuitive to figure out.
  • You have to unlock the plan to add goals, objectives, and interventions but dating is not flexible.
  • In other words, it’s not a “living” document that can be easily modified during each session.
  • Recently (as of late February 2022) changes to the treatment plan workflow have created more confusion for me (and I am persistent in figuring this stuff out).
  • The treatment plan workflow needs serious updating. When you juxtapose that to the increase in cost by $15 to add Wiley, things are disappointing in the regard…

REMINDER MESSAGES (voice, text, email)


  • Included in the monthly price (not an add-on like other EHRs). 
  • You can edit the email, text, and voice messages to include practice-specific information. For example, I use Doxy.me for telehealth rather than the S.P. Telehealth platform.  I’ve included my Doxy.me waiting room link in the reminder email and text messages for telehealth appointments.
  • You can type out the exact words the Voice reminder will speak.
  • Appointment Confirmations are a new feature but none of my clients have become accustomed to confirming, yet.
  • Using appointment reminders has reduced No Shows in my practice but they still occur on occasion. 
  • You can set up individual clients to receive both a text and an email reminder.

Cons – I can’t think of anything specific.



  • Claim processing is optional.
  • Inexpensive compared to paying a billing agency.
  • Once set up, it’s fast to submit.
  • You get to review the actual claim before submitting it.
  • Current cost choices (no more discount packages)
    • 25c per claim (first 10 are included in Essential Plan)
  • ERAs (Electronic Remittance Advice) are now available for download. This was a BIG improvement.
  • You can grant your biller access to deal with billing without giving access to clinical documents like progress notes and assessments.


  • The Medicare ERA (electronic remittance advice) doesn’t tell you if and where the claim was forwarded for secondary insurance processing (for comparison, Office Ally’s ERA includes all information so you can verify the secondary claim went to the right insurance company).
  • Clinicians/billers have no direct access to the clearinghouse that SP uses (Eligible, Inc).
  • Claims processed from Medicare don’t automatically adjust the Contractual Obligation (CO). You must do this manually for each Medicare claim (big downer). Claims processed from other insurance companies do generally automatically adjust the CO (but not the Medicare secondaries).
  • If there is an amount owed by the client after a claim comes through, deductible or coinsurance for example, there is no specific notification process to the clinician.  The information is there but it’s not obvious so you have to create your own practice management process look for it.
  • If a Medicare Electronic Remittance Advice (ERA) includes only claims that were assigned to the deductibles for each client (in other words a zero payment), then there is no Payment that shows up in the usual place (tabs = Billing; Insurance; Payments). You need to go through another heading to find the information then manually enter a Zero Payment and add the details for each client. This is time consuming and frustrating. There’s no logic to it from the clinician point of view.
  • The process to get set up with each insurance company for processing via SP’s clearinghouse is a bit labor-intensive.  By comparison, Office Ally and TherapyAppointment.com were much easier.
  • Medicare + Secondary claims:  If a client has a secondary insurance to Medicare, when the secondary ERA is processed, it is listed in SP (tabs = Billing; Insurance; Payments) as being from Medicare (you cannot correct this in the client’s account but you can correct it under the Payments list).  This is a serious issue with inaccurate information being reported to the clinician. Each payment from a secondary in this situation has to be verified elsewhere (from the paper check sent to you, the other insurance company website, your bank statement – ACH, etc.), then corrected in the Payments part of the SP system. 
  • Appointment Status feature is difficult to follow, often innaccurate in terms of Paid vs Unpaid appointment dates, nor is it easy to correct.
  • You have to pay extra to give your biller access.



  • The telehealth platform gives you the ability to send reminder messages with secure appointment unique links to your client.  
  • You can share your screen during session and the features have been updated recently.
  • The format looks professional. 


  • The Essential Plan which is currently $69 (previously known as the Professional plan which was $59) now automatically includes the SP Telehealth Platform. If you use another platform like I do, you are still stuck with paying for this feature with SP.
  • The Telehealth by Simple Practice client-facing app must be downloaded by your client.  Some clients don’t have this option on their device or they don’t know how to do it. 
  • Some clients are not able to download the app on their devices for various reasons.  If the client is using their cell phone for video appointments and is not tech-savvy or unable to add apps to their phone for any reason, you’ll have to use another platform for online video conferencing. This is the main reason I switched back to using Doxy.me.  
  • You might have some clients on a different platform because they can’t get Telehealth by Simple Practice on their device (which means you need to remember what each client is using and modify the office assignment accordingly).
  • The client must click on the Appointment Unique Link to access each appointment. No using an old link anymore which increases security but can be a problem if the client can’t find the email or text reminder or is using a device without incoming email attached to it (you must remember to send the Reminder by Text if they are using a cellphone in this case).



  • Help is obtained primarily via chat and email. 
  • The Help system has tutorials and a Community Forum.
  • In the Community Forum, you can ask questions and get information and answers from other SP users.
  • You can also make suggestions for improvements or vote on other customer suggestions.
  • Friendly Reps.
  • There is now an option to request a phone call in their Help request widget.


  • If email and text chat hasn’t solved your problem, you might need/want to talk to someone. It can be difficult to get someone on the phone for customer support, but it is possible by communicating with the person you’ve been emailing and text chatting with. There is no phone number published but they will send it to you if you ask.
  • Online tutorials are not always updated to new workflows Simple Practice creates.



  • Couples and Minor Management recently upgraded (I haven’t used this feature).
  • Billing “Ask the Biller” blog series – one example: (https://www.simplepractice.com/whats-new/insurance-payments-ask-a-biller-4/)
  • Community listserv for asking questions and getting useful information from other users.
  • Earn credit for referring others (thank you for using my link!).
  • Appointment Status Reports are helpful for finding Medicare clients in particular whose manual write-offs you may have missed when updating Payments. CON: The report is inaccurate for other purposes unless you’ve manually done the CO (Contractual Obligations) write-offs ahead of time. 
  • Daily Agenda emails sent in the early AM and Evening Summary emails from the system are helpful. The Evening Summary email lets you double check in a matter of seconds that you’ve written your notes for the day.
  • They offer a website landing page for your practice much like Psychology Today. It’s called Monarch.
  • They update processes and features frequently (unlike Therapyapppointment.com whose updates are announced but then drag on for years).


  • You might have to upgrade to the most expensive plan in order to add Billers, Schedulers, Supervisors, and extra clinicians. The cost can be shocking.
  • Auto Pay has some significant glitches, according to complaints I’ve read. I don’t use it. I manually send invoices and statements after I’ve created and reviewed them. PRO: It only takes a minute or two per client.
  • With the least expensive (Basic) plan, you cannot customize your note templates. This is a huge disappointment because this is probably the most important part of using an EHR.
  • Learning the “back office” particulars such as how to process clients’ invoices and statements can be frustrating.  The setup is not ideal in terms of billing clients after insurance claims have been processed. You must create Invoices before creating the Statement.
  • Invoices and Statements don’t include the insurance payment information. This is confusing for client and practitioner.  Invoices and Statements lack information that should be there and is normally included by your medical providers (insurance payments and contractual write-offs). 
  • There is no documentation within the client’s chart regarding emails sent (you can find an email list in the practice Reports section but not the actual emails and doesn’t include the content of the words you typed in the notification emails you sent).
  • There is no way to directly email your client within the system (e.g. “We need to change your scheduled appointment.”). The system will send only specific notification emails such as appointment reminder messages, invitations to access the client portal, notification the clinician has shared document(s), notification of an invoice or statement, and notifications of overdue invoices.  You can modify some of the email notification messages you initiate, but, again, the system doesn’t save them for you to look at later.
  • To document any emails sent and received outside the system, you need to copy and paste them into a Note (non-appointment Note) in the chart.
  • The system saves the secure text messaging you do with a client, but not inside their actual chart. So, you have to copy and paste them into a non-appointment chart note.
  • Some of the Reports are useless because the information is inaccurate.
  • Sometimes new features like Monarch appear to be higher priority and marketed heavily to clinicians when fixing problems that have been longstanding should be more important.
  • Starting in early 2022, Simple Practice updated its plans. In doing so, the cost increased. Things like Monarch and the Telehealth by Simple Practice video platform are included on the plan that allows you to modify/customize your forms. You pay for them whether you use them or not. This has enraged many of us including me. I hope for a “grandfathering” in to soften the blow of increased cost (this hasn’t happened as of Dec 2022).
  • Wiley Treatment Planners now cost an extra $15/month if you chose the Essential Plan.
  • You can’t carve out things you don’t need in order to save money on the Essential Plan.



  • Uploading a client’s records (in .pdf form) from another EHR system is fairly straightforward with the choice of uploading to individual client records or all client records as a whole. It’s tedious work no matter what platform you use, but it’s doable.
  • There are tutorials, videos, customer service, and a community forum to help you get through the setup and learning process.
  • There’s a Help chat service available during normal business hours.
  • Email requests for help are answered within a business day (my experience) and include detailed instructions with screenshots.


  • The system for getting insurances set up for claim submission is clunky and time-consuming (depending on the specific insurance e.g., Medicare or Medicaid).  Before you can set up a particular insurance for electronic claim submission, you have to enter a client with that insurance.  You can’t just get set up with all panels you are on ahead of time, which could mean a delay in submitting claims and receiving payment when you do get the first client with that insurance. Office Ally and TA’s systems were much easier. A workaround could be to add all the panels you are on to the fake client(s) in the system. That way when you get a real client with that insurance, you will have gone through the clearinghouse connection process and be ready to submit immediately after seeing your real client.
  • The tutorials for setting up your office need some updating.
  • Initial setup is not as intuitive or as guided as it could be but there is support.
  • No customer service phone number advertised. Waiting for email or chat help to get set up might be frustrating, but you can now ask to speak to someone in the Chatbox or request a phone call.

MOBILE APP for General Purposes (for the clinician only) Keep an eye out for a Client Facing App to show up


  • For in-person visits, you can securely take a photo, upload, and store your client’s insurance card directly from the SimplePractice mobile app (for the clinician only). There’s no need for a separate scanner, HIPAA-compliant software, or computer.
  • You can perform many everyday practice tasks from the clinician mobile app (scheduling, charting, secure messaging).


You can’t deal with back office things like certain billing things via the clinician app.


If you are not already familiar with billing practices, Simple Practice might be somewhat confusing until you learn the idiosyncrasies of their system in relation to the billing process. If you are naive about billing, it’s best to start out with someone with experience doing your claims and billing until you learn the ins and outs.

It has been totally worth the sometimes frustrating learning curve to switch over to Simple Practice for all that it offers for a price comparable to other EHRs. 

Simple Practice far exceeds TherapyAppointment.com’s Legacy system in terms of options and basic operations.  TherapyAppointment’s 2.0 system looks comparable to Simple Practice, but TA’s website still has a lot of old information related to their Legacy system, so it’s not clear where they are at with the rollout of their new system.

TherapyNotes is also highly rated by clinicians but you will need to investigate this closely to compare costs and options.

Office Ally’s EHR 24/7 is another option to look at. I haven’t used it though, so, like TherapyNotes, I can’t comment on specifics.

Click here to go to the Simple Practice website to see their current plans.
If this review was helpful, don’t forget to come back here for my link to start your free 30 days.

Here’s the discount referral link again

Featured Image by Luis Ricardo Rivera from Pixabay Modified.

If you are struggling with your private practice, check out my eBook on Amazon.

Are You Considering Private Psychotherapy Practice? Here’s What it Gives Me: Control

Listen to post via Soundcloud (spend 8 minutes out of your chair) or read below:

Listen to blog post via Soundcloud

Do you need control over your work schedule and environment? Private practice might be the answer. It was for me.

Why I Started Private Practice Years Ahead of Schedule

In late 2013, I took a break from work. I quit my new job, of only four months, at a local non-profit hospice for multiple personal reasons. After a year of considering my options alongside the reasons I needed that break, I started my private practice in my birth month (seems apropos now!), November 2014. The primary reason for pivoting away from employer-based social work is why private practice is still ideal. Control.

Because life is complex and flexibility matters a great deal to me, control over my schedule was a primary factor in pursuing private practice. That seems fairly simple, right? We all want control over when and how much we work. As you might’ve already guessed, it goes deeper than that. Much deeper.

The decision to quit hospice was difficult to make because that job had been on my career bucket list for years. At California State University, Sacramento (CSUS MSW ‘98), I’d put hospice on the list of job experiences I intended to obtain. I’d go to work for a hospice agency near the end of my hospital career, then pivot to private practice when I was a gray-haired social worker, with a nice retirement package, ready to rest my feet in a comfortable therapist chair. In 2002, after my brother died on hospice service, I modified my goal to include the hospice agency that had taken care of him. 

It turned out that after several years at the hospital, my feet got tired long before I had planned (a story for another time), and genetics graced me with a shocking amount of gray hair early on. 

Seriously, thank you, unknown ancestor! For making me get the question of dying my hair vs. going a-la-naturale out of the way permanently while my kids were still young! 

Plus, I was sick of the commute. I wanted to work locally and move on with my career.

In May 2013, I applied to the hospice agency on my bucket list. Boom! They hired me on the day of my interview. Check! A career on track. Do you recognize that feeling?

The two main events that led to quitting my on-call hospice position years before my original plan were personal. Complex, but simple and perhaps familiar to you depending on where you are in life.

Main Event #1 At the end of my month-long training period, my mother was diagnosed with metastatic breast cancer. It was the “sooner or later you will die from it” type. I knew she’d eventually be on the rolls of the agency I was working for. 

Two things happened in my mind: a) I wanted to be able to help when needed without jeopardizing my employment and b) I wondered how effective I’d be as a hospice social worker over the coming months, years, whatever time we had while she endured traditional treatment trying to buy more time with us. And, I really didn’t know how I’d be able to work while losing my mind over my mother’s death and seeing her name AT work when the time came. Then, there was the patient who was dying of breast cancer… 

Main Event #2 During my third and four months with hospice, my husband’s job started taking him out of town for weeks at a time. From the beginning of parenting, we’d agreed that he was the primary breadwinner. I was uber happy to be a stay-at-home-mom working per-diem on the weekends. For several years, our twins had great fun with their dad with no hovering mama, and I got to be a social worker interacting with adults at the hospital.  It had been perfect. The hospice job schedule was weekends only, too.

Because of his job change and unpredictability, our weekend plan wouldn’t work anymore. Our kids were not old enough to be left alone, day or night. Childcare was a problem, especially at a moment’s notice with my on-call status.

With all of life’s happenings (not in my plans!), I needed 100% control over my schedule. And for my health, I needed to have more control of my caseload while finding a way for maximum compassion satisfaction.

When the Going Got Hard

Private practice was and still is the answer. My mom passed in February 2018 and because I had flexibility and control, I was able to take the time off I needed to help her and be with her.

I still need control over my schedule for other family reasons. I need time for professional development to maximize efficacy with my clients e.g., grow skills while managing things that can lead to burnout (yes, the risk exists in private practice) and compassion fatigue (yep, that too).

I have control over my schedule which means I have a better chance of keeping life in balance. Well, the things I have control over anyway. I’m sure you know what I mean.

Through private practice, I’ve found a highly satisfying way of achieving one of my primary purposes in life: to help ease suffering. I get to help clients from the seat of my burgundy wingback chair with my coffee cup in hand. Feet resting and grounded. Whether in person or via telehealth, I can adjust according to life’s planned and unplanned events (and the random pandemic).

UPDATE February 2023 (not in the recorded version): Last summer (2022) I saw my last therapy client. After eight awesome years in the best. job. ever., I closed my therapy practice due to life demands. A family member needed me. I was able to close my practice on my terms, on my timeline, with careful planning and consideration.

Because I had control of the situation, I was able to transfer my clients to other therapists with confidence that they’d be well cared for.

I continued my consulting business on a limited basis. Freedom. I like it.

Are You Wondering How to Start Private Practice?

If this sounds like something you’d like to pursue, but you are unsure what the steps are for starting private practice, take a look at the table of contents in The 14 Concrete (but not so hard!) Steps to Private Practice.  This is how I did it. I wrote it down, and year after year I kept notes on the things I learned along the way. Then I transformed what I learned into a book.

How I achieved a full practice far ahead of schedule is in the details.

The Guide includes much of what I’ve learned along the way related to the steps. It doesn’t include every last piece of minutia though, because to be honest, that book would be too long and you’d give up the idea before even starting. I couldn’t even write it. Besides that, I learn something new every time I turn around. That’s part of what keeps me on my toes and is a natural part of private practice.

Private practice is one way you can gain control of your work life and experience deep compassion satisfaction at the same time. Can’t see yourself as a business owner? I can relate. I started with the goal of five clients. Within months, I’d achieved that goal and was ready for more. Being a business owner is just a matter of a learning curve. Like everything else you’ve learned along the way.

If you need help, I am here. Get the Guide (read more about it at the link) first, though. It will answer a ton of questions along the way. You might not even need me. That’s my goal: to help you as efficiently as possible and work myself out of a job. 

That’s why I wrote it. For you and for me.

Thank you for joining me today and don’t forget to follow my blog for the occasional post about private practice.

Get The 14 Concrete (but not so hard!) Steps to Private Practice – now available on Amazon

This book offers concise steps with helpful tips and tons of resources for Starting a Sole Practitioner Private Psychotherapy Practice.

Choosing a HIPAA Compliant Email for Your Psychotherapy Practice

I was recently asked about setting up a private practice email with HIPAA compliance in mind. The first two things to remember:

  • Your email is not technically HIPAA compliant unless you have a Business Associate Agreement (BAA) with the email provider
  • AND you use it properly.

In other words, there are limits to what you should send in an email message, even when set up with a BAA.

The following is from the newest edition of the Guide (in annual revision February 2021 and will replace the current edition). I use Google Workspace with a BAA, so you will see more details below regarding this option.

Here’s the info in the upcoming revision of the Guide.

Choosing Your Psychotherapy Practice Email

Figuring out which email service to use will take some time and consideration for cost and convenience. Your decision might be influenced by services you are already using.  

Both of those services offer additional features you will appreciate sooner or later.

Some Electronic Health Records (EHR) have integrated email in addition to Secure Messaging.

Secure Messaging within the EHR is the safest way to communicate electronically with your client because HIPAA Compliance is built into the EHR.  The client must sign in on their end to see the content of the message within their Client Portal.

While EHRs use email to send things like invoices, statements, superbills, reminder messages, informed consents, intake questionnaires, documents, and .pdfs, not all of them allow you to free type a general communication email. For example, you want to send the client resource information, but you’ll need to use an email system outside of the EHR.

I know, confusing…

Remember: Any email communication is a legal part of a client’s record, whether it is sent within an EHR or outside of it.

Emails to and from your client are considered e-PHI (electronic Protected Health Information). 

Remember: The email service must offer a BAA (and you need to find out how to obtain it after you sign up – some services require a phone call, others require flipping through a zillion web pages of instructions to find it).

It is generally recommended the only information you should communicate via email is regarding scheduling.

Before you communicate via email with a client, you must provide Informed Consent for email communication.  Here are a few examples (a simple Google search will provide many examples):

A disclaimer in your Email Signature is important as well.  Here’s an email disclaimer example:

The information transmitted is intended only for the person or entity to which it is addressed and may contain confidential and/or privileged material.  Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon, this information by persons or entities other than the intended recipient is prohibited. If you received this in error, please delete the material from any computer. Please note that gmail/email communication is not considered HIPPA Compliant for Protected Health Information.  By emailing or texting to (clinician name) you understand and accept the risk of email or text potentially not being secure.  Do not send Protected Health Information via email or text.


A client cannot “waive HIPAA” nor can they waive your responsibility to protect their Protected Health Information (PHI).  They can, however, consent to use of email and texting for specific information such as Appointment Reminder Messages (Informed Consent you require them to review and sign).



Consider Encryption (an extra layer of protection), but don’t stress too much about it: https://telehealth.org/hipaa-compliant-email/

Three HIPAA Compliant Email examples to check out (then do your own Google Search):

Hint: name.com is the URL so theoretically an email for this domain could be YourName@name.com.

Here’s mine: bonniemckeeganlcsw @ bonniemckeeganlcsw.net (spaces intentional to avoid spam bot crawlers). It’s too long, but I didn’t know what I was doing when I set it up. Learn from my mistake, make your name part shorter ;-). bonniemckeeganlcsw.net is another website URL (domain) I own.


Regarding that URL domain you may need for your new email (or you may be thinking about for a website address), you can purchase the URL domain for your future website without ever creating an actual website.

Assignment: Choose Your New Professional HIPAA Compliant Email

What HIPAA Compliant Email service are you using? Would you mind sharing with readers what you like or dislike about it?

Don’t forget to Follow Navigator News by Email so you don’t miss anything!

Original Image by Clker-Free-Vector-Images from Pixabay

Marketing: Writing Your Private Psychotherapy Practice Bio – An Exercise in Brevity & Specifics

This week I was asked if I could help with developing a bio for a new psychotherapy practice and deciding where to spend energy developing referral sources.  

This post is about the first half of the question: Your professional bio. After you’ve completed this exercise, then, where to spend energy (and time) developing referral sources will become more clear. The second half depends on your bio and your ideal client. I’ll post on possible places to spend energy developing referral sources next time.

Here’s the marketing exercise:

Write a letter of introduction. This is an exercise in brevity and specifics.  After you have a written your letter, then you can modify it according to the audience (the agency or person you are sending it to) and use it for the foundation for online sites like Psychology Today and Helppro.com.

It will also help you when you talk to people about your practice (they don’t want the long story – just the bullet list, the elevator speech).

Keep in mind your “ideal” client. For example, mine is an older adult on Medicare dealing with issues of aging. There is a multitude of issues older people are dealing with, making this is a broad enough net, but specific enough that it helps guide where I market myself (and how I screen out clients I don’t resonate with).

The following is a basic structure (use letterhead) you are free to copy. You can modify however makes sense to you, but keep it succinct. Your reader will skim and you may only have their attention for about 9 seconds. No joke, but probably you have a sense of how short our attention spans are.

Dear (so and so), 

I am writing to introduce myself and my new private psychotherapy practice in (location). 

I provide treatment via (HIPAA Secure online video conferencing and telephone, in-office, assisted living, home) to (adults, minors).

I offer (individual, group, couples, family sessions,…).

My special interests are (eating disorders, issues in aging, LGBTQ, attachment disorders in kids, domestic violence, relationships, caregiver stress,…). (If you use the word ‘trauma’ be specific because it is too broad and you probably don’t love to work with ALL types of trauma)

My experience includes (relevant types of places you’ve worked – but keep it brief e.g. county mental health, trauma medical center, residential substance abuse treatment – OR you can use names of agencies,…).

I have special training in (EMDR, hypnosis, CB,…).  (Remember that special training is great and looks good on paper, however, it is not the key to success in treatment or growing your referral base – the relationship is the most important part, so essentially you are selling your unique style, not that you have mastered a specific treatment.)

I accept (list insurance panels you are on, Medicare/Medicaid, cash pay, etc.). (I handle the billing so the client can get the help they need without the stress of reimbursement issues.)

(something that makes you stand out, if it is relevant – when you were licensed, grad school you attended, years of experience doing psychotherapy, insurance panels you are pending a contract with)

I am looking forward to connecting with you about any questions or referrals you have.

  • Respectfully,
  • Name
  • Phone number
  • email
  • website
  • (include a number of business cards according to how you see them distributed by the referral source – don’t send too many. Include a few flyers if you have one, but, again, don’t send too many and don’t worry if you don’t have one.)

While I don’t consider myself a marketing expert, I do know what worked for me and my colleagues who all have full practices. Like me, they turn away referrals consistently.

Writing this letter will help clarify things in our own mind and that will help with every piece of marketing you do.

I hope this helps as you figure things out. Follow my blog by Email so you don’t miss the next post.

I offer a free Q&A Hour to anyone who purchases the A Quick Guide to Starting Private Practice.

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