Starting your own behavioral health practice requires patience and commitment. The transition from being a clinician to a practice owner is challenging, but also offers unique rewards. In this article, we present a brief guide on how to start a therapy practice.

Navigating Legal and Regulatory Requirements

This is a category you should familiarize yourself with and revisit multiple times. A few important items to consider in this category are:

1. If you do not have one already, you will need to obtain a National Provider Identification (NPI) number from the federal government’s website. The NPI number is a unique, 10-digit number used to identify healthcare professionals throughout their careers.
2. Compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other laws/regulations is mandatory. In addition, complying with HIPAA protects your patients, your practice, and helps you avoid fines and penalties. Core HIPAA issues include securing your computers and physical spaces, only sending protected health information (PHI) through secure channels, keeping excellent records, and having a crisis plan for potential security breaches. Your EHR software can help with HIPAA compliance.
3. Obtaining consent from patients at each step along the way is a best practice that helps protect patients’ rights and privacy. Your EHR should allow you to customize your intake packets and allow patients and providers to eSign. Obtain consent from new patients to provide appointment reminders, to send PHI through a secure patient portal, to obtain medical records from past providers, and more. You’ll also want to ensure you are in compliance with the No Surprises Act.
4. Getting on insurance panels (also known as insurance credentialing) is an involved process that can sometimes take months and requires a lot of steps and paperwork. Get started early, as this can help bring in a steady flow of business.

It is important to seek legal advice on how to start a therapy practice, in order to ensure adherence to local, state, and federal laws and regulations. In addition, it’s a good idea to familiarize yourself with those laws in advance of seeking legal counsel.

How to Start a Therapy Practice: Establishing a Business Framework

Some of the “business basics” in this category include:

1. Make sure you are an up-to-date, licensed practitioner, and review state and professional websites for resources and tips.
2. Obtain your Employer Identification Number (EIN) from the Internal Revenue Service, which can be done online, for free. If your corporate structure is a disregarded entity (e.g., a single-member LLC), you will want to secure a business EIN and a personal EIN, to safeguard your Social Security Number.
3. Decide whether to be a sole proprietorship, a limited liability company (LLC), an S corporation, or other business structure. Check with your state government’s website. Fees will be involved, and you may have to file Articles of Organization or Articles of Incorporation.
4. If your practice will not have a brick-and-mortar office (i.e., telehealth only), open a P.O. Box at your local post office to avoid using your home address.
5. Open a business checking account at a bank or credit union. It is important to separate your business income and expenditures from your personal income and expenditures.
6. Apply for a city and/or county business tax license if required.
7. You may need a registered agent for legal purposes (such as service of process).

Finally, the most important task is to create a business plan. You may even want to complete your business plan before starting the above list. Going through this process helps you visualize how to start a therapy practice. Furthermore, it will help define your practice’s scope and purpose and account for the many concerns and expenses you will encounter.

Building a Strong Team

Assembling a skilled and supportive team can help your practice grow and succeed. If you are already an experienced practitioner, you may be launching your business with an existing client base, or the skills to quickly build one.

Hiring and/or contracting with administrative staff, clinicians, and support personnel may then be prudent soon after founding your business. You will likely want to pay for legal counsel, an accountant, and other experts on a fee basis. Those professionals will have important insights on how to start a therapy practice.

As your practice grows, a strong team will include front and back-office staff to handle patient communication, scheduling, billing, etc. For many behavioral health practices, another key hire is a prescriber. Adding medication management can make your practice more helpful and appealing to patients, as well as payers.

On the other hand, it may be best to build your team slowly. As your revenues grow and your workload increases, you may eventually need to hire staff and multiple clinicians. Using EHR software that includes role-based permissions can simplify the growth process. For further insights on effective hiring practices and fostering a positive workplace culture, check out our Growth Checklist Whitepaper.

Implementing Effective Practice Management Systems

Using the right technology can improve your practice’s workflows and efficiency. This includes EHR solutions that support functions such as intake, scheduling, clinical documentation, billing, patient communications, and offer a convenient patient portal.

An efficient practice management system should tie together these front-end and back-end systems, allowing things to flow smoother for your practice staff and patients.

Marketing and Branding Strategies

Your practice’s brand identity should be developed thoughtfully and intentionally. Although provider networks, referrals, and word-of-mouth are important for acquiring customers, you will also want to strengthen your online presence. For example, you can accomplish this with a professional website, a Psychology Today profile, a Google Maps listing, social media accounts, and paid marketing in digital and/or print formats.

Make sure to emphasize the areas your practice specializes in and how you can help prospective patients improve their behavioral health. It should be easy to contact you, and multiple methods should be available. This a critical part of how to start a therapy practice.

You may want to consult with a marketing specialist to solidify your brand identity and build an effective marketing funnel. Community outreach events and referral networks can also be a vital source of business.

Cultivating Patient-Centered Care

A patient-centered approach distinguishes many growing, successful behavioral health practices from others. A cornerstone of patient-centered care is the behavioral health treatment plan. This plan should be built in collaboration with the patient to gain buy-in and trust.

Integrate effective communication strategies to engage and retain clients from onboarding all the way through the patient care cycle. Your EHR software can help with this.

The basics of following through and following up are critical. Make sure you are always diligent and consistent. Build routines for your staff and for your patients that help them keep track and follow through with their treatment. This will help cultivate patient-centered care.

Balancing Self-Care and Professional Responsibilities

The challenges of balancing personal wellbeing with professional responsibilities can be overwhelming, especially if you are making the transition to owning your own practice while juggling responsibilities at home. Self-care is important for both practice owners and their teams.

Make sure to create boundaries that separate your work life and personal life. Also, set clear expectations for patient behavior, as well as staff behavior. Surprisingly, one of the most important items may be your software for scheduled appointment reminders! Cutting down on no-shows will improve patient outcomes, revenue, and provider satisfaction.

Billing is another major headache that can be reduced with the right software for handling clearinghouses, ERAs, superbills, and more. These and related items can help you manage your time and avoid overwhelm and burnout.

How to Start a Therapy Practice: Conclusion

Building a practice from the group up is a challenging but rewarding endeavor. Remember to stay committed to the ongoing learning process and embrace your adaptability. Seek mentorship from colleagues who have been down this path and build a community to help support each other.

If you follow the initial steps to get established and take the time to navigate the nuances of practice management, you’ll be well on your way to success.

References/Resources

https://nppes.cms.hhs.gov/#/
https://www.apaservices.org/practice/update/2006/06-21/applying-npi
https://www.apaservices.org/practice/business/hipaa
https://www.irs.gov/businesses/small-businesses-self-employed/employer-id-numbers
https://www.irs.gov/businesses/small-businesses-self-employed/single-member-limited-liability-companies
https://support.google.com/business/answer/7107242?hl=en&ref_topic=4854193&sjid=10278963000824234603-NC
https://join.psychologytoday.com/us/signup