u/liketheberry

By now, most of you have probably seen the Headway updates of taking $9.99 per client who books through Headway, as well as the mandatory annual note review.

Like many, this is my final straw for staying on Headway. I’ve already being toying with the idea of leaving, so this felt like the final push. However, I’m torn between self-credentialing with insurances or going fully private but offering sliding scales.

I have between 10-15 active clients on my caseload who are insurance clients. Some could afford my full rate ($135), while others definitely can’t or wouldn’t. I would like to get credentialed with the main insurance carrier that these clients fall under (BC/BS), but I have such an intense fear of audits and clawbacks and other horror stories that have been shared on this subreddit before.

I’m curious to hear other people’s thoughts who have been in this situation. What did you end up choosing? If you did go fully private pay, how did you broach that with clients?

Thanks in advance!

Hello! My second post of the day here lol.

I’m looking to move away from taking insurance for a multitude of reasons, which means I will also be leaving Headway. I know a lot of people have had varying success with getting referrals from Headway, but I actually got quite a few. So, I’m looking to find other directories to be a part of to mitigate that loss.

I’m still on Psych Today, but I barely get any hits. I’m also on Open Path which I’ve enjoyed a lot and have definitely gotten a handful of clients. From my understanding, Being Seen is Open Path’s full-fee directory. (For those who may not be familiar, Open Path is a directory for sliding-scale clients.)

Or should I just fork over money for a good website with SEO?

Curious to hear other’s thoughts and experiences!

Hi all,

I’m curious to hear how others operate with clients who aren’t scheduled on a consistent basis. I’ve notice a trend with some clients (particularly my college students or workaholic clients) that want to schedule via my client portal whenever they want a session. Sometimes these clients may go a month or two without scheduling something.

I have in my paperwork that 60 days passing without a session will result in closing the client’s file, though they are welcome to resume services when they want so long as I have the availability and they re-sign the informed consent paperwork. I’ve seen some people say they only wait 30 days, so I’m not sure which is considered “best practice.”

I know others have said it’s a liability to have a client active on your caseload who you aren’t seeing on a semi-consistent basis, so I’m wondering if there’s something I should be doing differently.

Thanks in advance!

ETA: I’m thankful for the help and thoughtful discussion everyone has given!

Hi all,

I work in private practice with a mixture of insurance, EAP, and private pay clients. I’m currently using Headway for my insurance clients, but with the recent platform changes, micromanaging, and the fact that Headway itself is backed by insurance companies, I’m looking to move away from taking insurance altogether and am wanting to supplement my caseload with more EAP clients if possible.

I currently contract with Lyra. While I’ve had mostly fine experiences with Lyra clients, lately it has felt like an influx of high acuity cases being put on my schedule. I’m not just talking about passive SI— I mean that clients who have denoted current intent, plan, and means have been put on my schedule for outpatient virtual services. My final straw was a client with HI who, once again, reported intent, means, and plan and only guaranteed 48-hours of safety being placed on my schedule. To refer a client back to Lyra, you can submit a form basically stating why you’re referring the client back. I’ve done this twice now but have never heard back if the referral was successful or not. I think the bigger issue here is why these high acuity cases are being screened as appropriate for outpatient virtual services. Others may have opposing thoughts on this, but being so early in my career, I’m just not comfortable working with these cases right now. I haven’t figured out if there’s a way to convey this to Lyra because 95% of the time the only way to get stuff done with them is through their AI chat bot.

Another issue I’ve run into with Lyra is I can’t tell you the amount of clients who do not fill out my informed consent paperwork in time for the intake appointment, have ignored my emails reminding them to do so, and then send me rude and incendiary emails when I won’t log on for the appointment 40 minutes past the start time once they’ve finally signed the paperwork. The fact this has happened multiple times makes me wonder if Lyra is preparing these clients for what to expect once they are scheduled with a provider. Maybe it’s just user error on the clients’ part, but it leaves a bad taste in my mouth.

Alllll of this said: Are there any other EAP platforms that you guys would recommend? I know Spring Health is one. I’m sure there are others and would love to hear feedback on which ones have been good to work with. I’m also looking into OpenPath to advertise my sliding-scale slots. Or, maybe there’s some people here who contract with Lyra who have suggestions on how to make it a more positive experience. I’m open to that, too.

Thanks in advance!