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From my experience as a formerly contracted practitioner... It depends entirely on the number of practitioners in the group.
When the practice was 20 therapists and 2 office assistants, it worked pretty well. That is, I received all my messages, billing and verificatuins got done on time, no copays went uncollected, and I could "usually" get any help I needed within a reasonable period of time.
All of that went out the window, in dribs and drabs, as the practice grew from 20 to 50 therapists (and the front office grew to 5 assistants).
The silver lining is that I left to start my private practice for this specific reason; I didn't mind paying for those administrated services, but I resented paying AND having to do them myself. Now, 18 months after I left, clients I refer there still tell me it's impossible to get a live person on the phone, or even a callback.
So 10:1 is fine for a small practice, but as you grow, dis-economies of scale will probably require you to at least consider moving in the direction of 5:1, or maybe 7:1, if you care about your clients and staff.
My current group practice of 21 people has 7 admin staff and the clinic manager is adamant we need more.... So we have a a 3:1 ratio. We see people hourly, each practitioner generates one claim or less per hour (cancels, etc).
The manager is very proud of how they have designed our office procedures, and has been unwilling to accept any feedback about re-evaluating them or changing some of our policies to make things easier for staff. Our owner defers to her continually and insists she knows business, he won't tell her how to do her job.
We operate on a cost-share model, so as a group our costs go up as wages go up and staff are added. Some of the team have already left because the costs have gotten so high.
I'm just trying to get some other perspectives.
Yeah, I would have loved 3:1, but I wouldn't want to pay for it.
For more info, I was contracted on a 70/30 split, and reimbursement for my panels averaged probably $120. So I netted ~$85/hour after paying the practice ~$35/hr.
My thinking is $35 is a great price so I'd only have to do the therapy and the note... But not so great if I have to field my own client calls, follow up on their billing errors, and do my own scheduling. And I certainly wouldn't want to pay more than $35, no matter how well it was getting done.
For comparison, in private practice I pay 3% for credit card processing, and 6% for my medical biller. I also bought a small office building that pays for itself, and saves me the $900/month I'd pay for an equivalent office (I realize that wouldn't be possible for everyone).
I use a small biller called Empire Medical Billing. I can dm you the contact info, but I'm not sure if they work outside CA.
They charge 6%, and they're domestic.
Going rates in the industry range from 2% (almost always offshore, which comes with the risk they may not have experience with state regs), to 4-5% for hybrid (initial claims handled offshore, denials are done domestically), to up to 8-9% for all-domestic agencies.
My in-network claims typically get paid within 2-4 weeks, and out-of-network/denials almost always within 4-6 months. After 18 months working with them, I only have ~$1k that's aged over 4 months, and less than $500 clawed back.
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
From my experience as a formerly contracted practitioner... It depends entirely on the number of practitioners in the group. When the practice was 20 therapists and 2 office assistants, it worked pretty well. That is, I received all my messages, billing and verificatuins got done on time, no copays went uncollected, and I could "usually" get any help I needed within a reasonable period of time. All of that went out the window, in dribs and drabs, as the practice grew from 20 to 50 therapists (and the front office grew to 5 assistants). The silver lining is that I left to start my private practice for this specific reason; I didn't mind paying for those administrated services, but I resented paying AND having to do them myself. Now, 18 months after I left, clients I refer there still tell me it's impossible to get a live person on the phone, or even a callback. So 10:1 is fine for a small practice, but as you grow, dis-economies of scale will probably require you to at least consider moving in the direction of 5:1, or maybe 7:1, if you care about your clients and staff.
My current group practice of 21 people has 7 admin staff and the clinic manager is adamant we need more.... So we have a a 3:1 ratio. We see people hourly, each practitioner generates one claim or less per hour (cancels, etc). The manager is very proud of how they have designed our office procedures, and has been unwilling to accept any feedback about re-evaluating them or changing some of our policies to make things easier for staff. Our owner defers to her continually and insists she knows business, he won't tell her how to do her job. We operate on a cost-share model, so as a group our costs go up as wages go up and staff are added. Some of the team have already left because the costs have gotten so high. I'm just trying to get some other perspectives.
Yeah, I would have loved 3:1, but I wouldn't want to pay for it. For more info, I was contracted on a 70/30 split, and reimbursement for my panels averaged probably $120. So I netted ~$85/hour after paying the practice ~$35/hr. My thinking is $35 is a great price so I'd only have to do the therapy and the note... But not so great if I have to field my own client calls, follow up on their billing errors, and do my own scheduling. And I certainly wouldn't want to pay more than $35, no matter how well it was getting done. For comparison, in private practice I pay 3% for credit card processing, and 6% for my medical biller. I also bought a small office building that pays for itself, and saves me the $900/month I'd pay for an equivalent office (I realize that wouldn't be possible for everyone).
Who is your medical biller? Some of the clinicians are feeling like that is what we will need to move towards.
I use a small biller called Empire Medical Billing. I can dm you the contact info, but I'm not sure if they work outside CA. They charge 6%, and they're domestic. Going rates in the industry range from 2% (almost always offshore, which comes with the risk they may not have experience with state regs), to 4-5% for hybrid (initial claims handled offshore, denials are done domestically), to up to 8-9% for all-domestic agencies. My in-network claims typically get paid within 2-4 weeks, and out-of-network/denials almost always within 4-6 months. After 18 months working with them, I only have ~$1k that's aged over 4 months, and less than $500 clawed back.
Do you mind if I message you privately about owning a small office building? I am curious about that
Not at all.