Collecting Fees Right from the Start
— Holly A. Hunt
Whether you are just getting started in practice or already established, there are many specific things you can do that are small, yet can make a big difference in your clinical and financial bottom line. By taking steps to streamline your costs, procedures, and policies, you can reduce practice hazards and effectively deal with them if they occur.
For example, one small step you can take is to collect client fees at the time of service. This will save you the work and expense of mailing bills and prevent delays and uncertainties in being compensated.
For insured clients, check their benefits before the first appointment to accurately assess their payment responsibility. By confirming with clients the exact amount and how they will pay, clients will be fully informed before coming to their first session. This will reduce the chances of misunderstandings and failure to pay once they arrive at your office.
To allow time to deal with problems if they occur, collect fees at the beginning instead of the end of the session. Clients can sometimes forget to bring payments or take a long time to find them in their purse, wallet, or pockets. By addressing fees in the beginning, you’ll have time to get compensated, solve problems, and still end sessions on time. You’ll be able to fully focus on providing service and avoid the stressful distraction of anticipating last-minute payment problems. Your subsequent clients will benefit as well when their sessions start on time and you can focus on their needs without residual stress of prior session delays.
To establish a precedent, introduce your policy in the first session after you’ve greeted new clients, collected forms, guided them to the therapy room, and briefly reviewed their reason for coming. Continue to collect fees at the beginning of every subsequent session. By staying consistent, clients will become familiar with this routine and may even organize payment in advance, reducing the time you’ll need for this task.
I discovered the value of this payment policy after many years of collecting payments at the end of sessions. Slowly but surely my stress accumulated as intermittent problems arose just when session time ran out. One day my inner light bulb flashed on and I realized these costs were too much; it was time to move payment to the session’s beginning for everyone’s sake. The next day I started right in, telling all of my clients when they first arrived “Instead of paying at the end of our sessions, I’d like to do it first thing to get it out of the way. That way we can spend the whole time talking about your concerns”. To my surprise no one became upset with this change, what I thought might appear a presumptuous request was taken in stride.
Now, when clients forget payment—and they still do—or are slow in paying, we have time in the beginning to figure out a solution. No overtime drain anymore. Those frustrating attempts to hurry people along at the last minute are gone. I can stay focused on clients’ issues, no longer wasting time and energy anticipating and confronting last minute problems.
If my previous problem sounds familiar to you, I definitely encourage you to reflect on your routine and move client payments to the beginning of each session. By taking small steps like these you can bring big benefits to your clients, your practice, and you.
Holly A. Hunt, Ph.D. is a psychologist in private practice in Southern California. Her article is adapted from her book “Essentials of Private Practice: Streamlining Costs, Procedures, and Policies for Less Stress” W.W. Norton, 2005. For more information visit www.EssentialsOfPrivatePractice.com
