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Developing a Profitable Telepractice: Hiring Consultants

Profitable TelepracticeThere are some basic steps to developing a profitable telemental health practice.  

  1. Earn a graduate degree
  2. Obtain a license to practice in your discipline
  3. Get specific telemental health training to understand legal, ethical and clinical, as well as technical issues
  4. Commit to a career path
  5. Select the right professionals to assist you

Obviously there may be other steps along the way, but if this path is enticing to you, part of your development as a successful professional is also dependent on knowing who you are not . . . and hiring the expertise you need to function optimally from the very first day.

Who are You?

Most likely, you’re not a Certified Public Accountant (CPA) . . . and you don’t need to be.  However, you might want to hire one. Before embarking on a private practice career, it is advisable to talk with a CPA to determine which business structure is best for your practice and your individual needs, which expenses related to a telepractice are tax deductible; how to minimize your taxable income, which types of bank accounts to open, etc.  You’ll need to define your business structure (e.g., limited liability company, s-corporation) before you credential with Medicare or other 3rd party payors.  A CPA’s advice in the development phase of your private practice can save you thousands of dollars in the long-run.

We’re guessing you’re probably not an attorney, let alone an attorney who specializes in telehealth practice.  While we are by no means suggesting that you keep an attorney on retainer, it’s wise to consult with an attorney to ensure that you understand telehealth law in the state where you practice.  Seeking the advice of an attorney can help you structure a practice that is in compliance with the telemental health laws and regulations that are pertinent to your success, including the tailoring of a telehealth informed consent document that meets not only your state law, but also the specialized needs of the clients/patients you treat.

We’re also doubting that you are a professional billing agent. Most mental health professionals are driven by a desire to help people, and billing them for this service can feel uncomfortable.  Billing agents can not only handle this time-consuming task, but can also provide some separation between the mental health service and the reimbursement process.  Most billing agents charge 7-9% of earned income for their services.  However, alternatives exist as many electronic health record (EHR) systems now include billing services for a lesser charge.  As we have discussed in previous blog posts, while there may be a cost savings with using your EHR, it’s important to realize that this will require an initial time investment on your part.  

Given your interest in telemental health practice, we’re not going to rule out the possibility that you’re an IT specialist.  Kudos to you if you are.  But if you’re not, it can be crucial to the success of your practice to have an IT specialist to ensure that your software and equipment not only work, but are also compliant with Medicare, HIPAA, and HITECH standards.  If you plan to rely on technology for your livelihood and you’re not an IT specialist, we recommend that you avoid a “Do It Yourself” approach to addressing your IT needs.  It’s well worth the investment to find an IT specialist with a background in telehealth to ensure the viability of your practice. These costs can be minimized by selecting a telecommunications technology vendor that is already HIPAA compliant and is willing to sign a Business Associate’s Agreement (BAA), and is possibly even available when you have a connectivity problem during a live session.  

You may also want to hire a clinical consultant to help you think more clearly about ethics, intakes, assessments, appropriate protocols, preventing as well as handling emergencies and termination with your specific client/patient populations. Thinking through these and many other important issues ahead of time will spare you undue worry and perhaps even more than a few sleepless nights.

Partnering with other professionals who can help support and structure your private telepractice will allow you the time and confidence you need to dedicate your energies to developing your successful telepractice.

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Shawna Wright, Ph.D.

Dr. Wright is a licensed psychologist in Kansas and Nebraska who works in private practice as a telepsychologist. She obtained her graduate training in clinical psychology from Texas Tech University specializing in child and family treatment. She worked for nearly a decade in community mental health in southeastern Kansas as outpatient therapist. She is currently an operations manager for two community mental health center offices. Through her experience in community mental health, Dr. Wright is acutely aware of the impact of the shortage of mental health providers in underserved, rural areas, and she sees the promise of utilizing telehealth as a medium for providing mental health services to this population.


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