Creating or solidifying business policies is essential for a healthy practice. Policies are a concrete way to set expectations for your clients and to decrease your practice’s liability. “If it is not in writing, it did not happen” is a quote that many in the mental health profession are all too familiar with. Written documentation of your work is a professional and legal necessity.
Fees
A common concern for clients entering treatment is getting hit with unexpected fees. Mental health treatment, especially for those paying out of pocket, can be an expensive endeavor. Nobody likes sticker shock, and everyone wants to know what they are paying for. Creating simple and clear documents clearly outlining fees can help build trust with your clientele.
Below is some information which may help you as you form official policies for your practice.
Cancellation Policy and Fees
One of the single most useful fee documents is a clear cancellation and fee agreement. Creating a protocol for what occurs when a client cancels within a certain time frame or does not attend an appointment signifies that your time is important. If you can agree with clients at the outset of treatment that there is a cost associated with a missed session (or multiple missed sessions), it is much easier to bring up attendance issues as they occur. My own experience has been that this is a common issue.
For more tips on how to create a cancellation policy, please see “Creating a cancellation policy”
Fee Agreements
The core tenet of a fee agreement is what you intend to charge per session. However, fee agreements often go beyond this by describing what you charge for other secondary services. For instance, do you charge clients to make collateral phone calls to their other providers? Is there a fee associated with them getting a copy of their medical records? What about a letter for an emotional support animal? Understanding the particular needs and requests of your clientele can assist you in exploring what secondary services you may be providing that do take up time within your practice. A fee outline helps you avoid having to put a price tag on a service “on the fly” which can create inconsistencies within your practice as well as mistrust with your client.
Receiving Payment
There are a lot of ways to pay for things these days. Venmo, Paypal, credit cards, checks, and cash are just a few of the most common ways clients may want to pay for your services. It is useful, from a business perspective, to look at the fees and the convenience of different payment methods. From there, you can let your clients know what method of payment is accepted at your practice.
Privacy and Consent to Treatment
Different states have different regulations on whether or not it is essential to get a signed document from clients expressly consenting to treatment. Whatever the state’s regulation is, it is wise to have a copy of a “Consent to Treatment” readily available. Clients have a right to know what services you provide, your confidentiality policy, and the limits and scope of treatment.
HIPAA compliance is non-negotiable for every practice, and all of us in the field need to understand the HIPPAA rules well. As practitioners we know that the correct storage and dissemination of medical records is key to ensuring a client’s right to privacy and limiting our liability and vulnerability to breaches. Clients have a right to know how you intend to keep their medical information safe and under what circumstances their medical records can be accessed. Having a written copy of this procedure means you can confidently discuss and privacy and HIPPA concerns with your clients as they are onboarded to your practice.
Emergencies
Varying practices have different protocols for after hour emergency response protocols. While some practices pay for an answering service, others might simply refer clients to local emergency service teams or local hospitals. It is a good precedent to review with your clients what your practice recommends if they experience a psychiatric emergency during hours that the office is closed. Having this conversation or a written notice of the policy, can be a way to establish rapport, and it acknowledges that you care for your clients’ wellbeing beyond when they are in session with you.
Staff
If you are a manager or are thinking of hiring additional staff, you will want to make your HR policies clear and concise. Policies may include defining expectations over dress code, time keeping, and non-discrimination clauses. Communicating via online presence is now commonplace in most practices. Other considerations include regulations around internet, email, and social media use.
Things to keep in mind when hiring is to see that the candidate is competent and aligns with your vision statement for your practice. Your vision statement sets your goals as an employer not just with your clientele, but with the community in which you practice. Simply being competent is not the only factor in hiring. It’s important, but not everything. Sharing goals and values goes a long way in employer-employee cooperation and benefits the clients as well.
If the unfortunate scenario of having to let an employee go should arise, remember to be professional and polite. You should have regular reviews of your employees’ work, so that when having to fire someone, it does not come as a surprise to that person. There should be fair warning that the employee is not meeting your standards before you get to the point of letting them go. Another policy I would recommend is to have another person you trust completely with you. If you do not have an HR person, then another trusted employee or colleague would be adequate. Some things are better done with someone at your side for support as well as to bear witness to events and words.
Business Policies in Practice
It can be a good practice to present your clients with your business policies upon initial intake. This sets expectations early enough that the client does not feel blindsided when you enforce them. As a practitioner, you can always utilize your clinical judgement when deciding where there might be some flexibility within your business policies.
As counselors, we operate in a complicated environment. We do not want to live in fear of litigation, but we certainly need to be constantly aware of potential legal implications. Miscommunication can ruin a business as fast as it can ruin a relationship. The best way to safeguard yourself as you enter the “business” of mental health is to set policies and systems clearly and thoughtfully. It can be intimidating at first, but establishing and writing business policies are necessary and essential for your financial and professional success. You don’t need an MBA to run a successful business, but you do need to have some basic components in place. Being alert to possible pitfalls can give you the head start and confidence you need to establish your own practice.
