Getting Paid: Fast, Easy, Convenient, & Cost-Effective Ways to Get Paid & Increase the Cash Flow in Your Practice
When clients pay for therapy in your practice, what type of payment do you accept?
Check? Cash? Credit Card? Debit Card? HSA or FSA Card? Money Order? Yes, they still issue money orders.
Today there are so many options to choose from for client payment. How do we decide which one is best for us and our practice? What are legal and ethical options available to therapists to get paid fast and not have to pay too much in bank or credit card charges?
This is the sixth article in a series on Getting Paid: Talking with Clients About Money Matters:
Not too long ago clients handed their therapist cash or a check before or after the session; were sent an invoice/billed at the end of the month; and then mailed or brought in their check or gave the therapist cash at the next therapy session.
Should you consider adding or changing the type of payment you accept for therapy charges?
How can a therapist decide which forms of payment are best for their therapy practice?
With whatever types of payment you decide to accept in your therapy practice, it’s important to look at how much it costs you or saves you—in time, energy, wait time for funds, as well as charges/money—to process those funds and get them into your practice bank account.
Therapists, like most small business owners, are always wanting to know what the best way is to get paid and increase their available cash. They want to know how to get their funds into the bank as quickly and easily as possible and how to pay the lowest possible amount to do that. Having earned this money, therapists want to take home as much of it as possible, save time, and have more clients.
In fact, the most common reason therapists give for accepting only check or cash is that it costs money (just under 3% of each transaction) to take credit cards. And, as you have probably heard, most therapists do not like to--or want to—pay any credit or debit card, or other type, of processing charges since this amount is subtracted from what the therapist is paid.
However, contrary to popular lore, whatever type of payment a therapist accepts for therapy sessions, it costs the therapist something. At the very least it costs time, energy, effort, and time before the funds can be accessed, and it can also cost money per transaction. How is it worth it for a therapist to take card and electronic payments and pay those transaction fees?
Giving your clients more ways to pay can increase the number of clients in your practice and improve your cash flow.
It's a fact that most clients expect to be able to use credit or debit cards when paying for things. Today’s clients, whether no matter what their age, find it convenient to pay via credit or debit card, or directly from their HSA or FSA. If you do phone, video or other types of virtual or remote sessions, credit card and electronic payments are essential because they enable the client to pay you before or after the session.
More payment options that are convenient means more access to care for a larger number of people—and result in more clients in your practice.
Whether a therapist accepts payment by electronic means--credit card, debit card, e-check, wire transfer, Zelle, Venmo, etc.—depends on both the therapist and clients’ preferences and needs. Many therapists find that their number of paid weekly client hours increase when they accept credit cards. Clients often like to get rewards--points or miles or cash back—when they pay for therapy.
If you don’t accept credit cards but accept checks or a bank transfer of funds, clients who want the rewards can use Plastiq. With Plastiq a client can pay with a credit card—and even split the charge between two different cards—and the therapist is sent a paper check or receives a bank transfer right away, just as if the client had paid with a credit card. Another benefit to the therapist with Plastiq is that the client pays the credit card processing fee, the therapist doesn’t. Many therapists love that because it means they receive all the money paid for the session.
For therapists, card and electronic payments can mean freeing up more time, energy, and effort—and quicker access to funds because of the following:
One way to increase income from your practice and not have to pay any transaction fees is to have your clients pay you using Zelle or Venmo.
One therapist I coached added Zelle to his practice in addition to credit cards as a payment option and increased his take home earnings $100 per month because he didn’t have to pay that amount in credit card fees. That was a very easy way to bring in $1200 more that year. Another therapist in one of my practice development groups added Venmo as a payment option when a client suggested it. When using Venmo, the client pays through the app at the end of the session—just a couple of clicks—then there's a ding on the smartphone, the therapist receives it, opens the app, clicks on the amount of the balance. then clicks on the deposit button. Voila! Two days later it’s in her account. If she wants it instantly then she clicks on the instant deposit button and pays a small fee, then it’s deposited in her account shortly after that.
Here are some descriptions of options for getting paid spelled out:
Credit Card processing companies that therapists report using are: Square, PayPal, Stripe, Ivy Pay or their bank. These companies also process debit cards and bank funds. These processors charge/keep a small percentage of the dollar amount of the transaction, usually just under 3%. Some therapists use a credit card terminal to swipe or insert cards—this is purchased from the card processor by the therapist—others use an app on their phone or tablet. I use the Square Terminal in my office and have it on my desk; it’s easy to read, insert cards in, and processes very rapidly. Very professional, convenient, and easy to use.
Venmo and Zelle transfer funds from the client’s bank account and deposits into the therapist’s bank account. They do not charge/keep any amount from the transaction. However, for instant transfers, Venmo does charge a small amount, equivalent to a credit card processing fee.
Plastiq, as described, charges the client’s credit card and deposits the full amount, no charge to the therapist, into the therapist’s bank account. The credit card processing charge is paid by the client in addition to the amount the therapist is paid.
HSA (Health Savings Account) and FSA (Flexible Savings Account) Cards are debit cards and are processed the same way. Clients who have HSA and FSA cards like to use those because they aren’t taxed on that income since it can only be used for qualified healthcare expenses—therapy is one. HSA and FSA cards help clients with high-deductible health insurance plans cover their out-of-pocket costs. Another thing to note about HSA cards is that contributions, up to the yearly IRS limit, can come from the client, the employer, a relative or anyone else who wants to add to the HSA.
So now you’ve had a presentation of a number of the options available to therapists for getting paid fast, and in easy, convenient, and cost-effective ways. By no means does this article include every option available to therapists as there are many more not mentioned here. Should you decide to add some new payment options to your practice it will, I’m sure, give you added time, money, and clients. See what differences these new options bring to your practice.
Getting Paid: Talking Pricing, Services, Rates—The Words You Use to Talk with Clients About Your Services and Rates Make a Difference
Talking with clients about therapy services, cost and payment, and the importance of making and keeping regular appointments is a vital part of therapy—and finding the right words to use professionally and clinically to convey the value of these services and the appropriate cost, time-frame, and involvement—is key to the success of every therapist’s private practice.
However, today many therapists are finding that they must spend significant time and energy to reset a client’s, or prospective client’s, expectations for therapy with regard to cost, frequency, duration, participation, and involvement in the therapy process.
As a result of these challenging money-driven clinical conversations, many therapists have reduced their rates significantly and are undercharging--and frequently being paid too little—for their therapeutic services. Yes, and, sadly, all too often, therapists are being persuaded to give their services away free.
This is the third article in a series on Getting Paid: Talking with Clients About Money Matters:
Unfortunately, it is a common misperception that charging as little as possible is the best strategy for attracting new clients and filling a practice.
However, undercharging and underearning seriously harm your business if you are mainly providing low cost offerings to clients—you and the work you do aren’t valued by these low-paying clients, you still need a lot of clients, and any new client makes very little difference to your income.
If you’re in private practice you have a responsibility to find clients who can pay your rates and keep you and your practice solvent so you can do the work you were meant to do instead of spending all your time and energy trying to keep you practice full.
The therapists I talk to are tired of undercharging and underearning.
Therapists want to work less, earn more, and make a bigger difference. More and more therapists are seeking out clinical and practice coaching so they can take charge of clinical money conversations and refocus them on the value, relief, and life/relationship/health changing/enhancing, conflict/anxiety/depression reducing benefits that clients are seeking from in person, face-to-face therapy work with a trained professional—and they charge more and are paid accordingly. Their income increases, they attract more clients, they fill their practice. Therapists deserve to earn a good living for the work they do.
The Wording You Use Can Make Difference in Your Income
As in any clinical endeavor, the words you use to describe your services do make a difference. In this case, the amount a client is willing to pay for therapy with a trained professional—and in order to receive the desired result/relief/outcome.
Yes, the meaning our words convey can either increase or decrease the amount of money we earn and are paid for therapy. You’ll find that people will pay in full and out of their own pocket for your services, when they believe you are the professional who can give them what they want—and the wording you use to describe your services conveys that.
Money Talk: Words & Phrases to Consider
Here are some examples of words that can make a difference in income when a clinician talks, writes, or communicates about therapy or money matters—and how and why these words can affect the perceived value, and subsequently, the amount a person is willing to pay for the therapy services provided as a clinician.
This information applies equally to face-to-face conversations in real time or virtually, to emails, texts, social media postings, and what’s printed in marketing materials or is on your website. Each one of these words and phrases can have a direct effect on the amount a client pays you for your clinical services.
As you read the following information, be sure to remember:
1. Help, Support, Advice, Listening, Guidance
Many therapists, clients, and lay people refer to therapy as: help, support, advice, listening, guidance, appointment, etc. When it comes to the amount of money a client is willing to pay for each of those ‘services,’ the perceived value and worth is low since these are things that non-professionals—friends, colleagues, neighbors, parents, siblings, support groups, online forums, etc.—can, and do, provide.
Exceptions to these would be: professional help/support/advice/guidance. These combinations have a higher perceived value of worth and price to clients.
Contrast the words: help, support, advice, etc., with the following ones that have a higher perceived value and worth: session, service, psychotherapy, counseling, treatment, recovery, consultation. Now combine them: psychotherapy session . . . therapy session . . . counseling session . . . psychotherapy services . . . therapy services . . . therapeutic services . . . professional services . . . depression treatment . . . anxiety treatment . . . bipolar treatment . . . trauma recovery . . . professional consultation . . . etc. These terms mean business. They are definite and professional. To clients they position you as a worthy professional who is both trained and capable of giving them what they want.
Other terms of higher perceived value that can be added when appropriate: licensed, certified, approved, supervised by, etc. Yes, clients will pay you more for your service when these words are added.
Here are two examples of lower perceived value wording: my services, services I provide. However, when you add other words to those two phrases you come out with higher perceived value: psychotherapeutic /psychotherapy services I provide. Add another certifier to that and you then have the highest perceived value: psychotherapy conducted by a licensed psychotherapist/clinician.
What word or terms do you, and your clients, prefer—or use—to talk about or describe the services you provide? Which would you or your clients pay a higher price for?
2. Ask, Get, Take, Accept, Charge
I ask $ . . . What I ask is $ . . . How much do you get for a session? I can take $ . . . The fee I accept is . . . I charge $ . . . What I charge is . . . What do you charge?
Are you asking or is it the cost? Are you asking or is it the price?
Be professional and definite: “The cost is . . ." not “What I ask is . . .”
State what the cost is for. “The charge/price/cost for/of the 60-minute session is . . .”
Here it’s important to remember that a client doesn’t “give you money,” a client pays for services rendered.
You have earned the money the client pays you. You’ve provided services to the client. In this case, services provided by a highly-trained professional—as therapists we have quite a bit of education, training, skills, and experience, not to mention licensure or supervision by a licensed person. Therapists deserve a fair rate of professional compensation.
Here are some alternative words and phrases to consider when stating the prices for the services you provide in your practice. Using these terms positions you and the services you offer as confident and of high value and worth:
The PRICE is . . . The COST is. . . The RATE is . . . The AMOUNT for that is . . .The session price is . . . the session cost is . . . the session rate is . . .The Price/Cost/Rate/Amount/Charge for that service is
Decide for yourself what fits you, your clients, and your practice best. Try a few of the phrases out. See what fits you best.
3. Free, discounted, reduced, lower
“No charge,” “no cost,” and “complimentary” are better wording for practice success than the word “free” which seems to mean to people that your services aren’t worth much and they should expect to receive all your services “for free,” all the time.
Discounted, discount, and reduced rate are popular words. Again, they are not the best for practice success as they train people to always ask for “a discount” or reduction.
A better choice in wording is “special” price/pricing or “introductory’ pricing, “a special offer” or even, “a limited time offer.” With these words and phrases, people associate your services as something of worth that are available at this pricing for a limited amount time.
Sometimes people ask if you have a “lower” fee or if you will “lower” the fee or even, “What’s your lowest fee?” Some better alternative words and phrases are an “adjusted” fee or “special pricing” or “professional courtesy” pricing or even “college student” pricing.
It’s important for mental health professionals as a profession to not train people to expect therapists to always reduce, discount, lower or charge the lowest fees just because a client wants but doesn’t need an adjusted fee.
It’s important that therapists, as a profession, maintain a reputation for being paid well for the good work they do—work that’s worth every dollar they’re paid. It’s not a good thing for therapists to be known for charging the lowest rates in town to anyone who asks even when they don’t need a price adjustment.
4. Fee Scale—Prices, Pricing, Rates, Fee Range
When talking numbers around the amounts you charge for your services, most therapists find it’s better received to refer to pricing, prices, and rates, as a “fee range” instead of a “fee scale.” Using the term “fee range” is associated with “a range of services and fees.” People seem to understand that concept easily. A fee range connotes choices and options whereas “fee scale” suggests some type of ranking or judgement.
That’s enough for today about money matters and getting paid. Next time we’ll address wording around sliding scale which is a whole topic in itself!
Lynne Azpeitia, LMFT
For 10+ years Lynne Azpeitia has helped therapists to live richer and happier lives through her workshops, private practice and career coaching, and her practice consultation groups which train, support, and coach licensed therapists, interns & students how to create and maintain a successful, thriving clinical practice and a profitable career