Everyone likes to save money. That’s especially true in private practice, given shrinking insurance reimbursements and rising costs. Here are a few areas where you can cut your expenses without cutting corners:


1. Offers from third parties to expedite payment

Agents like Multiplan work on behalf of insurance companies to persuade mental health professionals to take a steep reduction in payment (40% is not unusual) in exchange for getting paid within 10 days. They often target out-of-network providers after a patient submits a claim for reimbursement of out-of-network services. MultiPlan’s promotional online brochure boasts: “Our negotiators are trained to identify features on claims and bills that suggest continuing treatment is likely to occur, and can negotiate agreements on the entire episode of care rather than a single claim.”

These companies can be quite aggressive in pushing you to sign on with them. Many clinicians don't realize that they are under no obligation to accept their terms, and that payment is not even guaranteed. Also, most states have a "clean claims" law mandating prompt payment of error-free insurance claims. MultiPlan's 10-day window is a bit shorter; but is it worth your giving up 30% to 40% to the middleman to be paid a week or two sooner?

2. All-inclusive web design, web hosting and website management

TherapySites and similar companies offer to design a website for you, host it, manage it, and optimize it to be found on search engines - all for a monthly fee ranging from $40 to $70.

For mental health professionals who have hesitated putting up a website because it seems too complicated, this turnkey approach may sound like a good deal. However, over the long run, it's similar to renting a house full of furniture rather than buying. Yes, you get everything at once for very little money up front. But in the long run you pay through the nose.

If you sign on with TherapySites, you'll pay $708 per year. If you only need a website for one year (or maybe even two years) this is a pretty good deal, since it includes ready-to-use templates and other conveniences that can have you set up fairly quickly. Plus, they throw in a free 6-month listing in the PsychologyToday therapist directory, which is a $360 value.

However, the longer you have your website, the less of a good deal an all-inclusive website service becomes. After five years with TherapySites you'll have paid over $3500. This does include annual domain name registration and hosting. But you can get these on your own for less than $70 per year combined.

You can always leave an all-inclusive service, of course. However, check the terms of service. TherapySites stipulates that you can take all the content that you've written, but you can't take the web design, the layout or any of the functional modules. In other words, if you leave you'll pretty much have to start from scratch. And human nature being what it is, most people procrastinate on that, and continue to pay the monthly fee.

The alternatives to an all-inclusive service are to build your own website, or have it custom-designed. Building your own is not difficult, but it does take time. If you're not familiar with the basic technology and how to tweak it, it's best to have your first website designed for you. Most features described on the TherapySites promo page, such as a professional email address, search engine optimization, audio, video, contact forms and shopping cart, are usually included with customized website designs. The advantage of a professionally designed website is that you can have it customized to your needs and preferences. You don't have to stick to TherapySites' limited options.

It costs more upfront to have your website designed for you. But amortized over time, it's a better deal. Furthermore, you own all the files on your site, including the layout and design. You can move your entire site from one web host to another without losing anything.

The best way to find a web designer is to ask colleagues for recommendations. In addition, TPI has arranged for 5-10% discount off web design by psychologist Dr. Joe Altobelli, owner of MyPracticeSites. His work is top quality, both visually and functionally.

3. Cell phone service

If you've had the same cell phone service for a few years, you may be paying more than you need to. Wireless companies have become more competitive, and you can probably find a better deal with no contract required. Also consider buying an "unlocked" phone that is not tied to any specific carrier. That way you can switch without needing a new phone. Not all unlocked phones are compatible with all carriers. Here's a nice review.

4. Domain Names

Did you know that all companies that sell domain names use the same database? There's no advantage to purchasing your domain name through a company that charges $35 per year vs one that charges $12, unless you want some of the related products and services that they offer in combination with a domain name.

If you find a better deal than you've been paying, you can always switch to a different registrar. But check the terms of service of your current registrar. If they don't refund partial registration fees for unused time, you might want to wait until the end of your current paid-up term before you switch.

5. Credit card fees

Taking credit card payments is a customer-service convenience, which also provides cash flow for your business. (See this blog post.) When shopping for credit card processors, you'll find that some offer very low fees, such as 1.6%. Compared with flat fee processors such as SquareUp (2.75%) they might seem like a better deal.

But check the fine print. There may be monthly service charges, additional fees for reward and corporate credit cards, debit cards, and extra fees for accepting American Express. Since many folks use their credit cards to accumulate miles and points, very few of your transactions will likely qualify for the low rate offered by the processing company. They may also require you to sign a contract that locks you in for two years or more.

Photo courtesy of 401(K)2012 via Flickr