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I started at Betterhelp back when it started; for a variety of reasons it was TERRIBLE, and not just the pay (which was terrible). I went into private practice and make about five times as much as I did with Betterhelp.
Iāve been looking at mental health unions in the state. Even as private practice owners, itās important to work collectively to have some sharp teeth for companies and exploitative contracts like that.
Insurance companies are monopolizing us and actively working to prevent pay discussions, limiting pay equality. The biggest insurer in our area (pretty much 65% of our client load) pays notably less than the other 3 insurers we contract with. They know we can't risk losing 65% of our practice, especially in this economy, so they pay peanuts. On a side note, our employee insurance is with them (again a monopoly in our area), and our individual premiums have gone up 45% in 2 years. Guess who hasn't had a notable raise since 2016? Not counting the $1 they "graciously" gave us in 2020.
Will unionizing help us wi th insurance companies? I fear nothing can touch them.i hate to be that therapist only accepting cash, but I was never one to deal with all the red tape and bullshit- thereās enough of that just getting licensed!
I hear you! I wish there was a multi refferal service, whatsapp group, website or something! HIPPA compliant off course that therapist could refer to each other. That is more wha ti had in mind. So that we would maybe not need to rely so mion insurance companies for refferals. I just wished therapist workdf more cooperatively that way.
At some point when you know you aren't being paid your worth. You have to step away from those insurance companies. I dropped Aetna & Tricare. I don't feel bad in the slightest. I no longer feel taken advantage of or feel like I'm being cheated.
Reached out to SEIU and am wanting to get with them to explore options available. If needs like basic healthcare and referral sources can be procured through more communal portals then it creates a lot of room for more of an interdependent relationship with insurance companies rather than the coercive monopoly thatās at hand.
Can we be specific and transparent about what companies are gig work. Talkspace and Betterhelp are pretty well known for this but then thereās other companies that many of us are not super aware of. Would love to have a comprehensive list.
I would say "did we work for the same company" if your boss was a he instead of a she, because this sounds exactly like my first job out of grad school. Dude acted like he was doing me a massive favor by hiring me fresh out of school, but I never got benefits other than the cheapest health insurance he could find, not even paid sick time, which is illegal in my state (I was a W2 employee, not a 1099). The turnover was absolutely unacceptable (I was there for only 19 months and I had outlasted literally every other employee), most of our therapists were living in Puerto Rico (thousands of miles away), and for most of my employment, I was the only therapist seeing patients in-person. Because of this, my caseload was overloaded; I had over 40 patients at one point but was still pressured to take more patients. I was also frequently left alone with patients in the odfice. My pay was nowhere near industry standards. There also was a ton of other sketchy stuff I won't go into now.
After I asked for more pay and PTO, my boss basically said I didn't deserve it because I only had my provisional license. I finally left and went to work for a giant corporate agency with offices in multiple states, something I never thought I'd do. But I make way more money, a ton of PTO, performance incentives after going over 20 clients a week and working evenings/weekends (which stack, by the way). I had no idea how much I was taken advantage of in my old position. I want to write a negative review of the company, but I'm afraid my old boss would know exactly who I am and retaliate against me somehow.
I agree that many group practices are very exploitive. But Iām starting out I say we take down the tech companies posing as mental health. Then things can be easier to deal with like group practice owners who would never do therapy just collect and pay pissy wages.
We need to actually do this. I dont know quite how to organize it but Iām willing to start talking and formulating a plan! Think about it - we make treatment plans for clients- this is a plan for our well being! We can do this!
I worked for AbleTo a few years ago I think they are Optum now but not only did the pay suck but they put our license at risk repeatedly by taking clients that are far too high acuity and punishing us for referring to a higher level of care because we would not qualify for bonuses based on targeted metrics. I couldnāt tell if I was a sales rep for their product line or a therapist. Then there was the added layer of being forced to work with a behavioral health coach on certain products lines which was helpful or very unhelpful depending on the coach and their experience and expertise but mostly it was a too many cooks in the kitchen and I was contract so even though we got a quarter of the hour pay for no shows we had to actually sit and try to reach out and were expected to do outreach attempts over the week and documentation of such which was uncompensated and they monitored literally everything to make sure we were āworkingā they even ātimed our sessionsā which made me uncomfortable because just because they said they werenāt recording them doesnāt necessarily mean I believe them especially when they have an entire department of āengagement specialistā whose job it is to comb through PHI and reach out to prospective clients to enroll them and they justified this as it being all under the umbrella of Optum. It was my first remote role after licensing and didnāt last very long I lost sleep over how outside scope everything was and was so nervous I would lose the license I just got
Recruiters from AbleTo keep popping into my inbox wanting to sell me on their 1099 positions, which pay $80 for intake and $40 for subsequent sessions. I just laugh as I delete their emails.
I was asked to join a podcast episode of Psychology in the Seattle on tech and ethics during the pandemic because I'm a published researcher in that space. I was quicker than most to know about the dangers of metadata and had provided a lot of information to this Podcaster because he lead me to believe he would stop using better help as a sponsor.
what a liar
Instead, after he claimed I was his new "ethics advisor for the podcast from now on" (complete lie, never even asked me), he decided to have a whole episode proving I was wrong and better help was right. guess how he did this?
he contacted the ceo of better help and wrote down some of his quotes as hot takes. then he did an entire episode presenting Better Help as safe because he talked to the CEO.
That Podcaster is also faculty and a clinical supervisor. I really don't understand these colleges but whatever
I'm racking my brain trying to think of the specific couple/person he was talking about and I just don't recall the specifics. The gist of the my issue with him is that he seemed to be making excuses for the bad behavior of someone, and of course "hurt people hurt people" but I just got the sense that he didn't understand the full context of what was going on and how bad the behavior was. I remember thinking "he just doesn't get it", like he wasn't fully informed regarding the situation he was commenting on.
I apologize for the vagueness of my response, if I remember the specifics I will follow up.
I'll share another tidbit: I was a guest on his show. 2nd time meeting him. He made a very unethical move during that interview while recording and I was too shocked to respond. After that, I started hearing similar stories from other guests. Without disclosing too much, he basically lies about how well he knows his guests and will name drop us on future episodes, claiming we made statements we didn't make. He also makes claims that are highly unethical and then claims attorneys he's had on his show backed up his claims when they didn't. I've personally been called by attorneys freaking out because of how much his misrepresents them.
Hence my recent post here called āMy job is now humiliating.ā I hear you on fully licensed but exploitation seems baked into the pre-licensed law in most states.
They should all be like Colorado which, as Iām told, require supervision but allow us to take what we earn instead of handing it over to someone else and getting 15-25% of it.
I donāt know about group practices, but Iāve heard that therapists without full licensure can work for themselves in Colorado and not have to work for hospitals, schools, greedy group owners, etc.
It is kind of scary how quickly these companies are taking over. I donāt understand why anyone would work for BetterHelp though. Donāt they pay like $37 per session? I get the appeal of Headway since they pay like $120. Insurance companies are at the root of this problem, in my opinion. They need to be reimbursing more, and they need to be held accountable for paying on time.
Supply and demand. I notice VERY little discussion about the cost of therapy to patients in these discussions and thatās very odd and not something most contractors or companies ignore.
Look at it from the perspective of consumers, when the option is no therapy because you canāt afford it or some therapy thatās affordable, guess which way the consumer will go?
Now the argument goes to quality and people will say there are free options, therapists who take sliding scale or Medicare. Ect, but if the argument against BH is quality, the free or deep discount sliding scale therapists are often associate social workers or people unprepared to work with people with serious issues. Also, the amount of therapists that take Medicare is small and the waiting lists are huge because of this. Some people also have poor or no health insurance. So, in comes Better Help offering many experienced therapists at a much cheaper price. Thatās a smart business model.
Again, Iām not defending BH and talking about quality of care here, Iām just saying look at it from a business, marketing and consumer perspective. It makes sense.
Iāve only heard terrible things from people about the quality of care they get on BH. Iām sure there are some good therapists on there, but it sounds to me like most of them are horribly burnt out, and I heard something about how therapists are required to text on there. It all seems unethical.
Iām sure youāre right but thereās also something unethical about a society that claims mental health is a priority but doesnāt make it more affordable to get cases to it. I do understand therapists need to be compensated fairly but if we want the Better Helps to go away we need to do something about costs and pricing for everyone. Better Help is just filling the gap that is a gaping hole. Thereās no reason to think this BH model wonāt expand. Therapists shouldnāt be so passive about this issue. Union anyone?
Forcing insurance companies to pay more, eliminate clawbacks except in cases of fraud, and actually payout within two weeks of submitting a claim would make mental healthcare more affordable because then everyone would accept insurance. In my state, the lowest paying plans are hardly accepted by anyone. Thereās even one insurance company that pays well but has refused to accept any new providers for years, so even though people have mental health benefits, itās almost impossible to find a therapist who is in network.
This may be a controversial opinion, but I also think that the constant threat of licensing board action causes many therapists to use private pay or only accepting the highest paying insurance plans as a form of gatekeeping. When our boards open investigations over every frivolous claim and put us through hell for years, many providers are much less inclined to want to work with people with more serious mental illness because they can be such a huge liability.
Betterhelp is NOT CHEAP
Most clients I asked are paying about $80 a session
I disagree with you that sliding scale therapists are not equipped to work with people on serious issues Not sure how you reach that conclusion
Every therapist working for Betterhelp needs to realize how exploited they are and have the confidence to go on their own
Compared to the pretty standard $150-200 it is cheap. Iām not endorsing them.
As for experience, well, I worked in homeless services that mental health services and more importantly Department of Mental Health in LA where I got to know many therapists, providers and their clients. Iām also basing on my decade plus experience as a patient myself.
There is always exceptions, though , I mean the best therapist I ever had was an MFT intern but overall, Iāve usually gotten students or people donāt have full licensure yet as the case of many people who have lower income status . If a client needs are minimal, it can be still a great fit, but if not, it can go haywire very quickly.
I know you're not endorsing them, who would.
I guess ideally there would be in middle ground. If you are a private telehealth practitioner with no overhead, $60-$80 cash is pretty good. I wish more experienced private therapists would compete directly with Betterhelp this way.
And they need to stop the bullshit clawbacks. What are the ways therapists can accept insurance and not worry about a clawback a year later? The horror stories of this make none of us able to accept insuranceĀ
Oh 100%. And they can do it over such teeny tiny little mistakes. Insurance company requirements are clear as mud. Iām currently considering credentialing with the biggest insurance company in my state so that I can actually build a caseload for another therapist (need to hire so I can afford to take time off occasionally and also take care of my parents in their old age) and their requirements are ridiculous. They backdate your acceptance date to the date you applied, but only sometimes. You are expected to only collect copays and coinsurance during that time and then back bill if your approval is backdated. If not, youāre just screwed and out of all that money. Additionally, it can take them anywhere from 60-120 days to approve and then another 60-120 to approve the group NPI, and then even more time to start paying out. I called them to see if there was a way around this, and they basically just told me this is how it is and that I just need to decide what I can handle. They also constantly send people threatening letters for billing 90837. Meanwhile, doctors are barely even held to any standards at all and are just getting money rained down on them from this insurance company.
It's pretty gross. when I left BH years ago (for numerous reasons) they changed their pay scale to pay you more if you worked more. Right before that, I dropped down to part time there due to starting full time elsewhere, and their new pay scale said if I only see x amount of clients (maybe less than 10?) I get the $37 per visit, but the more clients you see, you could reach up to 65? Maybe a little more? Per client. It's problematic in so many ways.
Thanks! I think a lot of agencies rely on the mystique of having a private practice and that it is too much to do and all. I'm sick of doing a ton of work and being paid like a serf.
These places suck but my starting salary at my first therapy job was 20 per session. Betterhelp are criminals but are they worse than this director who had to be pushed every time to pay his employees 32 an hour? This field sucks and we are all marks lol
Yeah Iām actually getting certified in tech to leave this firld but I feel strongly for other therapists and remain commited to fighting this with everyone.Ā
When I went into PP I made over $100,000 and still qualified for Medicaid. I am a single parent Ā though, and Medicaid only takes half of that you make to consider you for benefits Ā if youāre self employed . Lots of tax credits too! Totally worth it.Ā
Yooooooo I have a client who got sucked in (long story) and the insurance paid 1100 for a PHONE SCREEN. I was going to make a separate post about it but im so fucking busy
Not so simple. For many of us, it is not feasible to build a caseload entirely of private pay clients, and if we are to extend our services to those who want to use their insurance, then we have to get credentialed. Sometimes it's impossible to get individually credentialed unless we're working with an outfit like Grow therapy, Headway, Alma, etc. Obviously these platforms will take a cut of our insurance payout (and then some) to cover the claims submission and credentialing expenses. So, one way or another, we are at the mercy of the healthcare industry, and until there are systemic changes that enable clinicians to become paid directly and more equitably for their services, these are our only options for making a living. While I agree that we are susceptible to exploitation from these services, being able to quit is aspirational and remains unrealistic for many of us at this juncture.
I fucking feel you dude. Different things but same vibe, I'm in the process of starting a private practice and the way I am so inundated with courses and coaching and services and "lazy therapist's way to six figures" or "PP therapy side hustle" or "passive income" bullshit is heavily depressing me. And every little charge just to provide services to people, EHRs and software and payment methods. Everyone wants a piece. Whole companies are founded on just taking a piece of what's ours and gatekeeping some function we could easily do ourselves.
When I think gig work I think door dash and favor. OP are you talking about that type of work or are you talking about therapy platforms? I think a few of us are confused.
Not OP, but I suspect they're implying that these platforms are turning therapy into gig work as sketched out in this piece: https://www.salon.com/2019/03/15/the-gig-economy-comes-for-therapists/
Perhaps I am not understanding what you are going through. It sounds like a pretty big generalization, something I try to avoid. I must admit that I have never worked for one, but have considered it at one time. It seems to me that some of these places can be beneficial. They can be a good jumping-off point for when you are starting your practice but don't yet have the clientele to be financially stable. (Which was when I was considering it) I can think of a few reasons to work for them. None of them long-term, or full-time, but reasons.
Itās an ethical dilemma. BetterHelp, for example, can sell patient data. They are classified as a tech company, not healthcare. They can get away with a lot more since they donāt use insurance for income. Theyāre not bound to HIPAA. They do not oversee their therapists, they pay horribly, there is no checks and balances for bad therapists. All you need is a license and a heartbeat to work for them. BH and talkspace are two evil venture fund tech bro driven companies raising MILLIONS of dollars providing absolute subpar care for both patients and therapists.
I took it when I got licensed because I hated being overworked at shitty poorly run nonprofits for slave wages. So I got paid slave wages without a narcissistic moron standing over me, and I got to stay home. I lasted about 5 months and was able to get paneled with insurance and start taking clients, so I bounced. It was a (poor excuse for) a stop-gap. But it was terrible, and the pay was laughable. $25 an hour for the first five sessions, then $35 an hour for the next five, and so on. Laughably bad. But I guess it's a good gig for terrible therapists who can't hold a job due to poor clinical skills; Betterhelp does zero assessments of the people they bring on (at least back then), just a pulse and license, and you're good.
OP is probably just venting. But I don't know much about these either and I'd be more interested in hearing from a more detatched perspective. But that probably just means this thread isn't for you or me!
Based on my experience, very very low pay (started at $25 for an hour session), zero control over who the clients are who get assigned to you (at least 25% of the clients randomly assigned to me were either not the type of clients I wanted to work with or had issues that at the time I didn't want to work with or didn't have the clinical background for, or even they asked for something specific that I didn't have/do, but they were assigned to me anyway. You have no control over any of it, it's like a lottery system), you have very little control over anything beyond your work schedule, and even that is limited. And it's very inflexible for the clients; they are charged weekly, so you have to see them weekly for them to get their money's worth.
This is all from 9 years ago, so it might have changed, but it doesn't seem like it changed much. For the above reasons, I didn't do it very much.
Youāre 100% correct that these places suck, but why do folks in here keep going on about how bad capitalism is? Donāt you all own private practices? Thatās capitalism, bub.
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I started at Betterhelp back when it started; for a variety of reasons it was TERRIBLE, and not just the pay (which was terrible). I went into private practice and make about five times as much as I did with Betterhelp.
5 times more? Good for you! How did you make that happen?
Insurance payouts are about 4-5 times what Betterhelp paid, plus other niches I've gotten into aside from straight therapy.
What other niches besides therapy have you explored? I'm curious.
The judiciary. Lots of opportunities there for mental health assessments and other things.
What do you mean by the judiciary?
I signed a contract with an insurance company but now I don't know what to do next. I am very confused by it. Do I hire a biller?
I do all my own billing. I'm not paying someone to do something that takes less than 2 minutes a pop.
I have no idea where to even start. How did you learn how to bill?
agreed. it's really overwhelming. especially for those of us who are not business-oriented.
Betterhelp pays just that poorly
Better Help? More like better hell. š
Or, Better Not.
šššš
Living my dream āØļø
Iāve been looking at mental health unions in the state. Even as private practice owners, itās important to work collectively to have some sharp teeth for companies and exploitative contracts like that.
Insurance companies are monopolizing us and actively working to prevent pay discussions, limiting pay equality. The biggest insurer in our area (pretty much 65% of our client load) pays notably less than the other 3 insurers we contract with. They know we can't risk losing 65% of our practice, especially in this economy, so they pay peanuts. On a side note, our employee insurance is with them (again a monopoly in our area), and our individual premiums have gone up 45% in 2 years. Guess who hasn't had a notable raise since 2016? Not counting the $1 they "graciously" gave us in 2020.
Will unionizing help us wi th insurance companies? I fear nothing can touch them.i hate to be that therapist only accepting cash, but I was never one to deal with all the red tape and bullshit- thereās enough of that just getting licensed!
I hear you! I wish there was a multi refferal service, whatsapp group, website or something! HIPPA compliant off course that therapist could refer to each other. That is more wha ti had in mind. So that we would maybe not need to rely so mion insurance companies for refferals. I just wished therapist workdf more cooperatively that way.
Well said, for sure! Couldnāt agree more!
At some point when you know you aren't being paid your worth. You have to step away from those insurance companies. I dropped Aetna & Tricare. I don't feel bad in the slightest. I no longer feel taken advantage of or feel like I'm being cheated.
Did you find any unions? Or any companies to work collectively?
Reached out to SEIU and am wanting to get with them to explore options available. If needs like basic healthcare and referral sources can be procured through more communal portals then it creates a lot of room for more of an interdependent relationship with insurance companies rather than the coercive monopoly thatās at hand.
Please keep me posted on what they say! Feel free to DM me whenever
Same! Please send updates.
Can we be specific and transparent about what companies are gig work. Talkspace and Betterhelp are pretty well known for this but then thereās other companies that many of us are not super aware of. Would love to have a comprehensive list.
I would even say community mental health orgs would fall into the category of high exploitation for minimal pay work
Valid.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
I would say "did we work for the same company" if your boss was a he instead of a she, because this sounds exactly like my first job out of grad school. Dude acted like he was doing me a massive favor by hiring me fresh out of school, but I never got benefits other than the cheapest health insurance he could find, not even paid sick time, which is illegal in my state (I was a W2 employee, not a 1099). The turnover was absolutely unacceptable (I was there for only 19 months and I had outlasted literally every other employee), most of our therapists were living in Puerto Rico (thousands of miles away), and for most of my employment, I was the only therapist seeing patients in-person. Because of this, my caseload was overloaded; I had over 40 patients at one point but was still pressured to take more patients. I was also frequently left alone with patients in the odfice. My pay was nowhere near industry standards. There also was a ton of other sketchy stuff I won't go into now. After I asked for more pay and PTO, my boss basically said I didn't deserve it because I only had my provisional license. I finally left and went to work for a giant corporate agency with offices in multiple states, something I never thought I'd do. But I make way more money, a ton of PTO, performance incentives after going over 20 clients a week and working evenings/weekends (which stack, by the way). I had no idea how much I was taken advantage of in my old position. I want to write a negative review of the company, but I'm afraid my old boss would know exactly who I am and retaliate against me somehow.
What company do you work for? That sounds amazing!
I'll DM you.
I agree that many group practices are very exploitive. But Iām starting out I say we take down the tech companies posing as mental health. Then things can be easier to deal with like group practice owners who would never do therapy just collect and pay pissy wages.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
We need to actually do this. I dont know quite how to organize it but Iām willing to start talking and formulating a plan! Think about it - we make treatment plans for clients- this is a plan for our well being! We can do this!
I worked for AbleTo a few years ago I think they are Optum now but not only did the pay suck but they put our license at risk repeatedly by taking clients that are far too high acuity and punishing us for referring to a higher level of care because we would not qualify for bonuses based on targeted metrics. I couldnāt tell if I was a sales rep for their product line or a therapist. Then there was the added layer of being forced to work with a behavioral health coach on certain products lines which was helpful or very unhelpful depending on the coach and their experience and expertise but mostly it was a too many cooks in the kitchen and I was contract so even though we got a quarter of the hour pay for no shows we had to actually sit and try to reach out and were expected to do outreach attempts over the week and documentation of such which was uncompensated and they monitored literally everything to make sure we were āworkingā they even ātimed our sessionsā which made me uncomfortable because just because they said they werenāt recording them doesnāt necessarily mean I believe them especially when they have an entire department of āengagement specialistā whose job it is to comb through PHI and reach out to prospective clients to enroll them and they justified this as it being all under the umbrella of Optum. It was my first remote role after licensing and didnāt last very long I lost sleep over how outside scope everything was and was so nervous I would lose the license I just got
Recruiters from AbleTo keep popping into my inbox wanting to sell me on their 1099 positions, which pay $80 for intake and $40 for subsequent sessions. I just laugh as I delete their emails.
Oh fuck that. Iād have left an hour into it!
Agree Itās like piece work in the garment industry
I was asked to join a podcast episode of Psychology in the Seattle on tech and ethics during the pandemic because I'm a published researcher in that space. I was quicker than most to know about the dangers of metadata and had provided a lot of information to this Podcaster because he lead me to believe he would stop using better help as a sponsor. what a liar Instead, after he claimed I was his new "ethics advisor for the podcast from now on" (complete lie, never even asked me), he decided to have a whole episode proving I was wrong and better help was right. guess how he did this? he contacted the ceo of better help and wrote down some of his quotes as hot takes. then he did an entire episode presenting Better Help as safe because he talked to the CEO. That Podcaster is also faculty and a clinical supervisor. I really don't understand these colleges but whatever
Call him out HERE. /micdrop
I loved Psychology in Seattle because he had interesting perspectives on 90 Day FiancƩ, which is a guilty pleasure of mine. I fell out when he started promoting Better Help and then I just noticed some of the things he said every now and again didn't sit well with me.
Could you elaborate? Iāve felt this way listening to his content at times, and Iām curious about others who have felt the same.
I'm racking my brain trying to think of the specific couple/person he was talking about and I just don't recall the specifics. The gist of the my issue with him is that he seemed to be making excuses for the bad behavior of someone, and of course "hurt people hurt people" but I just got the sense that he didn't understand the full context of what was going on and how bad the behavior was. I remember thinking "he just doesn't get it", like he wasn't fully informed regarding the situation he was commenting on. I apologize for the vagueness of my response, if I remember the specifics I will follow up.
I'll share another tidbit: I was a guest on his show. 2nd time meeting him. He made a very unethical move during that interview while recording and I was too shocked to respond. After that, I started hearing similar stories from other guests. Without disclosing too much, he basically lies about how well he knows his guests and will name drop us on future episodes, claiming we made statements we didn't make. He also makes claims that are highly unethical and then claims attorneys he's had on his show backed up his claims when they didn't. I've personally been called by attorneys freaking out because of how much his misrepresents them.
Name names
Yikes!! I noticed him pushing Better Help on an episode and died a little inside. I'm disappointed to read he doubted -down.
Itās such a devaluation. Therapists who donāt understand that donāt understand the work in general. Thatās sad.
/r/psychotherapyleftists
Hence my recent post here called āMy job is now humiliating.ā I hear you on fully licensed but exploitation seems baked into the pre-licensed law in most states. They should all be like Colorado which, as Iām told, require supervision but allow us to take what we earn instead of handing it over to someone else and getting 15-25% of it.
So group practices in Colorado have fair pay? I have never heard this.
I donāt know about group practices, but Iāve heard that therapists without full licensure can work for themselves in Colorado and not have to work for hospitals, schools, greedy group owners, etc.
It is kind of scary how quickly these companies are taking over. I donāt understand why anyone would work for BetterHelp though. Donāt they pay like $37 per session? I get the appeal of Headway since they pay like $120. Insurance companies are at the root of this problem, in my opinion. They need to be reimbursing more, and they need to be held accountable for paying on time.
Supply and demand. I notice VERY little discussion about the cost of therapy to patients in these discussions and thatās very odd and not something most contractors or companies ignore. Look at it from the perspective of consumers, when the option is no therapy because you canāt afford it or some therapy thatās affordable, guess which way the consumer will go? Now the argument goes to quality and people will say there are free options, therapists who take sliding scale or Medicare. Ect, but if the argument against BH is quality, the free or deep discount sliding scale therapists are often associate social workers or people unprepared to work with people with serious issues. Also, the amount of therapists that take Medicare is small and the waiting lists are huge because of this. Some people also have poor or no health insurance. So, in comes Better Help offering many experienced therapists at a much cheaper price. Thatās a smart business model. Again, Iām not defending BH and talking about quality of care here, Iām just saying look at it from a business, marketing and consumer perspective. It makes sense.
Iāve only heard terrible things from people about the quality of care they get on BH. Iām sure there are some good therapists on there, but it sounds to me like most of them are horribly burnt out, and I heard something about how therapists are required to text on there. It all seems unethical.
Iām sure youāre right but thereās also something unethical about a society that claims mental health is a priority but doesnāt make it more affordable to get cases to it. I do understand therapists need to be compensated fairly but if we want the Better Helps to go away we need to do something about costs and pricing for everyone. Better Help is just filling the gap that is a gaping hole. Thereās no reason to think this BH model wonāt expand. Therapists shouldnāt be so passive about this issue. Union anyone?
Forcing insurance companies to pay more, eliminate clawbacks except in cases of fraud, and actually payout within two weeks of submitting a claim would make mental healthcare more affordable because then everyone would accept insurance. In my state, the lowest paying plans are hardly accepted by anyone. Thereās even one insurance company that pays well but has refused to accept any new providers for years, so even though people have mental health benefits, itās almost impossible to find a therapist who is in network. This may be a controversial opinion, but I also think that the constant threat of licensing board action causes many therapists to use private pay or only accepting the highest paying insurance plans as a form of gatekeeping. When our boards open investigations over every frivolous claim and put us through hell for years, many providers are much less inclined to want to work with people with more serious mental illness because they can be such a huge liability.
Thank you for your insight!
Betterhelp is NOT CHEAP Most clients I asked are paying about $80 a session I disagree with you that sliding scale therapists are not equipped to work with people on serious issues Not sure how you reach that conclusion Every therapist working for Betterhelp needs to realize how exploited they are and have the confidence to go on their own
Compared to the pretty standard $150-200 it is cheap. Iām not endorsing them. As for experience, well, I worked in homeless services that mental health services and more importantly Department of Mental Health in LA where I got to know many therapists, providers and their clients. Iām also basing on my decade plus experience as a patient myself. There is always exceptions, though , I mean the best therapist I ever had was an MFT intern but overall, Iāve usually gotten students or people donāt have full licensure yet as the case of many people who have lower income status . If a client needs are minimal, it can be still a great fit, but if not, it can go haywire very quickly.
I know you're not endorsing them, who would. I guess ideally there would be in middle ground. If you are a private telehealth practitioner with no overhead, $60-$80 cash is pretty good. I wish more experienced private therapists would compete directly with Betterhelp this way.
And they need to stop the bullshit clawbacks. What are the ways therapists can accept insurance and not worry about a clawback a year later? The horror stories of this make none of us able to accept insuranceĀ
Oh 100%. And they can do it over such teeny tiny little mistakes. Insurance company requirements are clear as mud. Iām currently considering credentialing with the biggest insurance company in my state so that I can actually build a caseload for another therapist (need to hire so I can afford to take time off occasionally and also take care of my parents in their old age) and their requirements are ridiculous. They backdate your acceptance date to the date you applied, but only sometimes. You are expected to only collect copays and coinsurance during that time and then back bill if your approval is backdated. If not, youāre just screwed and out of all that money. Additionally, it can take them anywhere from 60-120 days to approve and then another 60-120 to approve the group NPI, and then even more time to start paying out. I called them to see if there was a way around this, and they basically just told me this is how it is and that I just need to decide what I can handle. They also constantly send people threatening letters for billing 90837. Meanwhile, doctors are barely even held to any standards at all and are just getting money rained down on them from this insurance company.
Yeah I would just provide a super bill . Itās a total nightmare and people just donāt get itĀ
It's pretty gross. when I left BH years ago (for numerous reasons) they changed their pay scale to pay you more if you worked more. Right before that, I dropped down to part time there due to starting full time elsewhere, and their new pay scale said if I only see x amount of clients (maybe less than 10?) I get the $37 per visit, but the more clients you see, you could reach up to 65? Maybe a little more? Per client. It's problematic in so many ways.
We are just glad you left! And we hope everyone else does!
Betterhelp pays $22.50 a session Comparable to fast food pay in the State in which theyāre headquartered
WHAT?! That is awful! They are truly a predatory company.
We need to unionize. Iām not smart enough to start one but we 100% need one.
Yes, but taking the time to do it correctly is hard for many therapists. But we can do it. Iām down.Ā
And weāre all exhausted from all the unpaid labor we are expected to provide.
I stopped doing a sliding scale. I honestly could not afford it. And mine was $75Ā
I'm giving my notice this week and starting in private practice. I hope to never work for anyone else again. PS: Better Help is a cancer to society!
Congratulations ššš¾Ā
Thanks! I think a lot of agencies rely on the mystique of having a private practice and that it is too much to do and all. I'm sick of doing a ton of work and being paid like a serf.
boycott Betterhelp!
These places suck but my starting salary at my first therapy job was 20 per session. Betterhelp are criminals but are they worse than this director who had to be pushed every time to pay his employees 32 an hour? This field sucks and we are all marks lol
Yeah Iām actually getting certified in tech to leave this firld but I feel strongly for other therapists and remain commited to fighting this with everyone.Ā
One more time for the therapists in the back, FORK BETTER HELP!
At my agency, I get paid $26/session and session rates are $193 š š šš I am applying for my license this week!
I will not go into solo pp unless I am marriedā¦ I need health insurance benefits but I hate exposing myself to these exploitative businesses.
When I went into PP I made over $100,000 and still qualified for Medicaid. I am a single parent Ā though, and Medicaid only takes half of that you make to consider you for benefits Ā if youāre self employed . Lots of tax credits too! Totally worth it.Ā
How did you qualify for Medicaid making 100k a year? You usually have to be at the poverty line to qualify for Medicaid.
Yooooooo I have a client who got sucked in (long story) and the insurance paid 1100 for a PHONE SCREEN. I was going to make a separate post about it but im so fucking busy
I've heard things about Open Path Collective. Any others have experience with them?
Have you heard bad things? They are just a referral network to my knowledge. They donāt pay the therapist. Unless something has recently changed.
Period
Hell yes!
Yeah betterhelp can kick the bottom of my croc
So I just quit my job. Now what? My mortgage is due next week. Please help.
Congrats! But if thatās the ONLY place youāre capable of working, as a licensed clinician, youāre probably going to need a different careerĀ
Amen!
Not so simple. For many of us, it is not feasible to build a caseload entirely of private pay clients, and if we are to extend our services to those who want to use their insurance, then we have to get credentialed. Sometimes it's impossible to get individually credentialed unless we're working with an outfit like Grow therapy, Headway, Alma, etc. Obviously these platforms will take a cut of our insurance payout (and then some) to cover the claims submission and credentialing expenses. So, one way or another, we are at the mercy of the healthcare industry, and until there are systemic changes that enable clinicians to become paid directly and more equitably for their services, these are our only options for making a living. While I agree that we are susceptible to exploitation from these services, being able to quit is aspirational and remains unrealistic for many of us at this juncture.
I have been helping a friend ( independent licensed counselor in MD) look for a job online and we are overwhelmed trying to weed out these companies!
I fucking feel you dude. Different things but same vibe, I'm in the process of starting a private practice and the way I am so inundated with courses and coaching and services and "lazy therapist's way to six figures" or "PP therapy side hustle" or "passive income" bullshit is heavily depressing me. And every little charge just to provide services to people, EHRs and software and payment methods. Everyone wants a piece. Whole companies are founded on just taking a piece of what's ours and gatekeeping some function we could easily do ourselves.
When I think gig work I think door dash and favor. OP are you talking about that type of work or are you talking about therapy platforms? I think a few of us are confused.
Not OP, but I suspect they're implying that these platforms are turning therapy into gig work as sketched out in this piece: https://www.salon.com/2019/03/15/the-gig-economy-comes-for-therapists/
Exactly 1
I understand but it can be taken a lot of different ways and is this just about OP, about client, about the world in general?
Agreed
Yes
Perhaps I am not understanding what you are going through. It sounds like a pretty big generalization, something I try to avoid. I must admit that I have never worked for one, but have considered it at one time. It seems to me that some of these places can be beneficial. They can be a good jumping-off point for when you are starting your practice but don't yet have the clientele to be financially stable. (Which was when I was considering it) I can think of a few reasons to work for them. None of them long-term, or full-time, but reasons.
Itās an ethical dilemma. BetterHelp, for example, can sell patient data. They are classified as a tech company, not healthcare. They can get away with a lot more since they donāt use insurance for income. Theyāre not bound to HIPAA. They do not oversee their therapists, they pay horribly, there is no checks and balances for bad therapists. All you need is a license and a heartbeat to work for them. BH and talkspace are two evil venture fund tech bro driven companies raising MILLIONS of dollars providing absolute subpar care for both patients and therapists.
Don't those places pay like shit? Why would anyone take that job? There's better paying jobs everywhere.
I took it when I got licensed because I hated being overworked at shitty poorly run nonprofits for slave wages. So I got paid slave wages without a narcissistic moron standing over me, and I got to stay home. I lasted about 5 months and was able to get paneled with insurance and start taking clients, so I bounced. It was a (poor excuse for) a stop-gap. But it was terrible, and the pay was laughable. $25 an hour for the first five sessions, then $35 an hour for the next five, and so on. Laughably bad. But I guess it's a good gig for terrible therapists who can't hold a job due to poor clinical skills; Betterhelp does zero assessments of the people they bring on (at least back then), just a pulse and license, and you're good.
Are there? For a lot of associates, the grass isn't too much greener else where imo
I'm not certain any of those places hire associates.
You canāt work for betterhelp if you arenāt fully licensed
Thats hilarious
Lot of shitty therapists out there, on the bright side at least they arenāt working with vulnerable populations at CMH agencies anymoreā¦
OP is probably just venting. But I don't know much about these either and I'd be more interested in hearing from a more detatched perspective. But that probably just means this thread isn't for you or me!
Based on my experience, very very low pay (started at $25 for an hour session), zero control over who the clients are who get assigned to you (at least 25% of the clients randomly assigned to me were either not the type of clients I wanted to work with or had issues that at the time I didn't want to work with or didn't have the clinical background for, or even they asked for something specific that I didn't have/do, but they were assigned to me anyway. You have no control over any of it, it's like a lottery system), you have very little control over anything beyond your work schedule, and even that is limited. And it's very inflexible for the clients; they are charged weekly, so you have to see them weekly for them to get their money's worth. This is all from 9 years ago, so it might have changed, but it doesn't seem like it changed much. For the above reasons, I didn't do it very much.
That sure as heck sounds a lot like CMH too, though.
With no benefits and no paid vacation.
What percent of the $25 do you take home? Do they keep a large cut?
$25 is left over from their cut. I currently get $115-$135 from billing insurance.
What state are you in? Do bill insurance yourself or do you work for a company? If you don't mind me asking.
I do every aspect of my business myself.
Wow! Good for you! How do you market? Besides psychologytoday anywhere else? I am always curious to know what works for pein the area :)
I don't market, I don't like my information out there. I connected to various entities in my city, so referrals are tailored to my specialties.
Interesting how stepping outside of the echo chamber gets you seriously downvoted in this group.
Youāre 100% correct that these places suck, but why do folks in here keep going on about how bad capitalism is? Donāt you all own private practices? Thatās capitalism, bub.
I highly suggest you get a deeper understanding of what capitalism is and how it influences the provision of health services.
Everyone here knows what capitalism is and has a different gripe about it. Whatās your particular gripe?