Scheduling policy changes
One of the biggest challenges that I have discovered in private practice is how often appointments are getting missed. In my 1-year retrospective, I discussed the fact that about half of the scheduled intake appointments I had, never arrived. To add to that, a number of clients who I was able to meet for their intakes, would eventually go through a string of cancelled and missed appointments, leading to an early and unplanned discharge.
At the present moment, my attendance policy allows for two back-to-back missed appointments and/or and three missed appointments in a 3-month period before I reach out to confirm attendance or consider discharge. For clients who are committed to therapy despite the attendance struggles, we discuss the time we are scheduled for and if it still makes sense, as well as consider an agreement for attendance for the next 2-4 sessions.
This has helped, however I still find myself the occasional week where a rash of cancelled and missed appointments leads to only a few (out of a part time, 10 hour schedule, that means 1-3) completed sessions, and that has a strong affect on income overall.
While fluctuating income is a staple fact of private practice, those rough weeks are definitely causing issues overall. In my case, this has necessitated two changes:
- More intentional efforts to reschedule clients during the same week, both during scheduled times and off-hours;
- A reduction in the number of medicaid/Husky clients being accepted at this time.
This has been a hard decision to make, as currently medicaid clients take up almost the entirety of my caseload, and I believe that there are a lot of excellent clients who have medicaid insurance. However, due to the standing policy that medicaid clients are not able to be billed for cancelled and no-showed appointments, I am out of options if a scheduled intake is not met, or if a client disregards their appointment time. I intend to continue taking medicaid clients for part of my caseload, however, so if you are on medicaid insurance and you are interested in working with me, please email me and I can try to work with you.