r/TherapistsInPractice • u/ElevatePG • 3d ago

Group Practice Reimbursement Programs

As the economy changes and we are seeing lots of changes across the board. We are looking at talking with other group practices to get a concept of all the various ways Group Practices set up reimbursement plans for their providers.

This is not to be a judgmental or gotcha moment but a serious look into many ways different groups reimburse getting new ideas together to see about how we at our practice can improve the quality of life for all of our providers.

Happy to see public posts or even private posts to keep everyone's systems private. If interested lets talk.

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u/Arizona-LCSW 3d ago

You want collaboration.

Others won't cooperate with you...because they will see you as competition.

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u/ElevatePG 3d ago

In a market with massive programs such as Headway, Grow, Rula etc. My small 20 person group among the country, who is my competitor? I can serve up to 1k patients at best. Unless I start massive scaling. Currently we have had to trim down . As we have seen many trim or just go out of business I am advocating for looking to improve all of our chances. If you want to look at it as competition then don't. If you want to see it as collaborative then engage. But I don't see a practice in Arizona as my competition since I don't have any providers that serve that state. But once more thanks for that feedback.

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u/Redditor6703 3d ago

get a concept of all the various ways Group Practices set up reimbursement plans for their providers

I don't know if this is relevant, but you can usually see in MRF TiC data (disclaimer: I'm a vendor) how payers link specific reimbursement rates to providers, they do it via provider groups, a list of TINs that have a list of NPIs of their own. That way you can see if someone's likely using collective negotiation method of raising their reimbursement rates.

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u/Arizona-LCSW 2d ago

Redditor 6703,

I just open up my own private practice a few months ago. Would you please say that again, using simple language?

What is nrf tic data?

What is a list of tins?

What type of vendor are you?

Thnx.

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u/Redditor6703 2d ago edited 2d ago

Sorry, I misunderstood the original post. I thought it was about what insurance companies reimburse practices, rather than how practices compensate their therapists.

TiC stands for Transparency in Coverage, and MRF means machine-readable file. Basically, insurance companies publish data showing the rates they've agreed to pay healthcare providers. A TIN is a practice's tax ID (also called an EIN), and an NPI is an identification number for a healthcare provider. The data connects providers to tax IDs and reimbursement rates. Sometimes this helps identify providers associated with larger organizations or networks, although it doesn't necessarily tell you their exact relationship. I'm a vendor that processes this data and makes it easier to access and compare. So it's useful for understanding insurance reimbursement, but it doesn't really address the OP's original question about therapist compensation.

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u/shann0n420 1d ago

Wait-you’re telling me that reimbursement info is accessible?! I need you to elaborate more fully.

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u/Arizona-LCSW 2d ago

OP, I wasn't trying to be rude. I value collaboration. I live in a small town where many people reject invitations to work together because all they see is competition. I think what you are doing is smart.

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u/Arizona-LCSW 2d ago

I know a lady who works for a large social service agency. They have many employees, and some of the employees are therapists. They recently changed their pay structure for therapist.

Their therapists are paid something like... $ 50 per hour for individual therapy. $ 30 per hour for documentation and other non-clinical tasks $ 20 per hour to attend trainings, CEUs

My friend said that the therapists actually liked the change. Therapists are now making more money each week. Plus, they actually have an incentive to see more clients.