It wasn’t until a few years into my private practice, that I really questioned why the dollars weren’t quite adding up the way I wanted them too. My caseload wasn’t totally consistent, which meant my bank account had too many peaks and valleys.

As an entrepreneur, that’s a hard way to live life. It’s kind of the feast and famine mentality and it’s easy to just chalk it up to the nature of therapy services. However, I didn’t want to live life that way so I decided to take a look at where I was potentially losing the most money in my practice and how I could correct the situation.

There are many areas of a therapy practice that directly correlate to earnings.

How much are you charging for your services?

Do you have a sliding scale?

What fee do you receive on average from your clients?

Do you charge different fees for different services?

Do you run groups, workshops, lecture, teach, etc.?

How well are you tracking client payments, missed appointments, and upholding your policies?

How consistent are your referrals?

How many sessions do you do in a week?

How many prospective client calls do you convert to new clients?

When I decided to look into why I was falling short of my financial goals by thousands of dollars a year, I was able to say that I had a really good foundation established on all of the above questions except two…

My biggest problem was that my weekly number of sessions were fluctuating too much, because my conversion rate on prospective client calls were too low.

At the time, I was probably converting around sixty percent of prospective clients to new clients that stayed in my practice beyond a few sessions.

On one level, it’s not a terrible conversion rate. For every six out of ten people that reach out they actually pursue therapy with me. However, I wanted to really look at it from a business perspective.

In order to make this sustainable, where I felt I can live my life and not worry about whether the practice would take a nosedive, I had to address the area that I identified had the most room for growth. I wanted to get the conversion number between eighty to ninety percent. And after lot’s of trial and error, here’s a list of the key factors that kept my conversion rate near ninety percent for years.

Whenever Possible Answer the Phone

I never realized how important this was until I made every effort possible to answer the phone. Unfortunately, without administration support we cannot always do this. But as soon as I started answering the phone more, I noticed an increase in the amount of initial weekly conversations I was having with prospective clients. If clients have a few names, they very well may call each one until someone picks up the phone. I’m also guilty of that when I’m seeking out new services.

Spend the “Right” Amount of Time on the Phone Call

The first phone call is key. Depending on your style you may only have 5 to 10 minutes with them. It’s so important that they feel heard, but also that they feel you can help them. If you let them talk for the entire time and only say a few words, many people will feel like nothing is happening. However, if there is a really healthy balance of listening and inserting yourself with questions, empathy, connection and hope, clients are much more likely to want to come see you in person. My preference is a short phone call to get them into the office. If the phone call is too long, there’s a lot of space for clients to feel disconnected without face-to-face time.

Get Them In The Office as Quick as Possible

Clients typically want to start today. They usually wait to call a therapist until things feel pretty difficult. If you can arrange your schedule so you can get new clients in the office within 24 to 48 hours you position yourself as the therapist they most likely will see first. As simple as this sounds, many clients choose the therapist they see first. They are eager to get started. If you have a good connection with them, they will often stop looking for someone else and move forward with you.

The Art of Initial Consults and Assessments

Whether you do an initial consult or go straight into an initial assessment, it’s a very important time to establish rapport, while also showing that you have something of value to offer. In the very beginning of my practice, I was a little to hands of in the initial consults, doing too much listening and not enough talking. My conversion rates suffered, because people want to be heard by someone who can help them in ways that are different from their friends and families. Whenever there’s an opportunity for a small therapeutic intervention it can leave a tremendous impact on the client. Impact will turn prospective clients into new consistent clients.

Discussing Fees for Services

Here’s another big make it or break it moment. Do you take insurance? Are you self-pay only? Do you slide? How to handle all of this?

It turns out a lot of money is lost in the process for many therapists. When I didn’t quite know how to handle the conversation I often had too many clients paying a low fee on my sliding scale. I wasn’t taking insurance and lost too many clients that inquired about it without exploring fees further. If someone asks if you take insurance and you don’t, the next question is if they have out-of-network coverage. If they don’t know it’s important to help them find out what their coverage is. For behavioral health, many out-of-network coverages are almost as good as in-network. For self-pay, it’s my recommendation to first ask for your full fee. When we lead with a sliding scale, a high proportion of clients will underpay even if they can afford more. That can add up to so much lost money a year. If they challenge the full fee, then it’s a good time to bring up a sliding scale if you have one.

As a responsible entrepreneur, your business requires you to learn where it’s losing money in ways that are unnecessary. Converting more prospective clients into your practice that are a good fit is good for your business, but is also good for their healing. Sometimes, just by looking deeply into the lost opportunities in a practice, you will be amazed at how many thousands of dollars a year were drifting away.

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Keith Kurlander

Keith Kurlander is the founder of Higher Practice, a company dedicated to helping therapists achieve their highest potential in private practice. He has two decades of combined experience in business administration, group facilitation, teaching at the undergraduate and graduate level, yoga instruction and as a licensed professional counselor in private practice.

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