Jeremy Sharp (00:00.568)
Hello everyone and welcome to the testing psychologist podcast. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner and private practice coach.
Jeremy Sharp (00:13.826)
Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others and I just keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com slash therapynotes and enter the code testing. This podcast is brought to you in part by PAR.
The NEO inventories normative update is now available with a new normative sample that is more representative of the current U.S. population. parinc.com forward slash NEO. Hey everyone. I am back today with a business episode. I’m talking with Bree Christman from Bosco. She’s the founder and CEO of Bosco, which is an operations management company that works 100 % virtually with mental health.
practice owners. She has over 15 years of experience in the project management operations fields, and she’s taken a different approach to making an impact on businesses. She has revolutionized the way businesses operate by introducing the solution for overwhelm for practice owners. Her commitment to being human first has led to her serving practice owners and folks in the mental health field specifically, which is the unique niche.
Like I say in the episode, I’m very grateful for folks in these ancillary fields who have chosen to take us under their wings and help us with business things. So today we’re talking all about onboarding. And when I say onboarding, I mean that whole process of getting clients into your practice and into their first appointment. And you might think, okay, there’s not a whole lot to say about that, but as we dive into the episode, I think that will become clear that there is actually quite a bit that goes into the
onboarding process. So we start with an overview just of operations in general and then quickly move into a deep dive about the onboarding process. So we’re talking about what should your website look like and what are your calls to action to get clients to reach out? What do you do with those calls to action? How often do you follow up to get people scheduled? How many follow ups do you do? What does the onboarding process look like once they’re in your practice? How do you send paperwork? So all kinds of questions like that. So if you
Jeremy Sharp (02:35.906)
have ever found yourself with questions or feel like there might be gaps in that process in your practice, this is a great episode for you. And before we get to the conversation, of course, we are coming down to the wire as far as openings in my mastermind coaching groups, which start in the first week of February or on the first week of February. So if you’re interested, if you’re a practice owner at any stage of development and you’d like to join a group and get some support and some coaching to take your practice to
whatever stage you’d like to take it to, you can go to thetestingpsychologist.com slash consulting and get a pre-group call to see if it’s a good fit. All right, with that said, let’s get to my conversation with Bree Christman.
Jeremy Sharp (03:23.99)
you
Jeremy Sharp (03:32.462)
Welcome to the podcast.
Hey, thank you, Dr. Jeremy. I appreciate it. Dr. Jeremy.
Dr. Jeremy. I’ll take it. take it. You know, I usually just do Jeremy and any opportunity to bring him.
Give the credit where credit’s due. I’ll do Jeremy the rest of the podcast.
Okay, that’s fair. That’s fair. That was my moment of glory here. Yeah. Thanks. Thanks. I’m excited to chat with you. for many reasons. One is because you are, you live like 10 minutes from where I grew up in the small town area of South Carolina, which is totally crazy. We figured that out and connection with you. Yeah. Yeah, it really is. So there’s that.
Jeremy Sharp (04:15.63)
But then you’re also going to talk with me about operations and onboarding in our practices and that’s also a topic that I think a lot of us need some help with. So I’m glad that you’re here. Thanks for being here.
Thanks for inviting me. was excited that we got, you know, we talked one month or two ago about what it would look like for me to come on the podcast, especially not being a therapist. so, you know, being able to talk about something that we’re really passionate about. And also we can help therapists with is really, really great. Yeah.
Yeah. Well, we’re always grateful for, you folks out there who choose to make a career out of helping us. So that’s maybe a good place to start. I would love to know, you know, like why this is important. Why pick mental health psychologists, therapists, for your, for your target audience, I suppose.
Yeah, so we actually, it was kind of a fluke, but it’s a fluke that I’m glad that happened. So when I first started my company almost five years ago, I got some clients that were therapists, and then our company grew solely off referrals. And of course, those referrals came from therapists and then were therapists, and then 90 % of our clientele were therapists. And so we really dug deep and figured out, you
Where do we want this to go? And so we love working with therapists of all kinds. We love being in the mental health space. I’m very passionate about mental health and making sure that we can advocate for ourselves and people who can’t advocate for themselves. it was great. And, I wasn’t called to be a therapist. I was called to be an operations person. And this is kind of my way of being able to make it an impact. But why it’s important to us, you know,
Brie Chrisman (06:05.612)
this world that we live in is so chaotic and it’s, we’re getting bombarded all the time with so many situations and issues and things. And, you know, as a practice owner, there are 8,000 and a half things that you have to do probably on a daily basis. You’re carrying such an emotional load with your clients, but then you have a business to run as well. So what we, what
I am passionate about is making sure that we can take the burnout out of owning a practice. So that way, practice owners mental health is a little bit better. And that trickle down effect, which you see all the time, you know, when people’s mental health is improving the trickle down effect in their family and the people that they interact with. that trickles down to associate therapists and that goes on to their families and their clients and so on and so forth. So it’s kind of our little rock in the pond.
of how we can help, you know, help mental health.
Yeah, yeah, yeah. I love that. I think we forget about that, you know, as practice owners. I’m speaking for myself. You know, it’s easy to just take things on and keep going and, you know, end up maybe. mean, I don’t know. I don’t know if I’d use the word burnout as something that has happened, but even like people have burnout as sort of like the rock bottom kind of place.
Yeah. But even leading up to that, like if you’re at you know, eight or nine out of 10, you don’t have to be at a 10 out of 10 for it to affect your work and your employees and your clients.
Brie Chrisman (07:47.918)
You don’t have to be a five out of 10. I mean, really. But a lot of therapists that we work with are kind of at that, have hit that proverbial wall where they’re like, I just want to burn it down and go back to being like a solo provider with no EHR, just doing things on Google Docs and just running with whatever app-based payment. Or they want to grow.
but they can’t because they don’t have the systems in place or like the training time to train people or way to onboard new people. And so they come to us and they’re like, I literally don’t know what to do. Or they’ve grown too fast and then everything is breaking. So it’s kind of one of those three things really. it’s all the solution is the same for every single one.
Ooh, that sounds really nice. We’re going to talk about that. Yeah. Yeah. I’ve experienced all of those things at different points. Yeah. I’m guessing there are people out there who also have. So note to self, if you are considering burning everything to the ground and going to Google Docs and, you know, a paper calendar, this might be for you. Yeah. So I would love to just tell people like what your company does. It’s probably nice just to set the stage and then.
go a little bit deeper into this whole idea of operations and onboarding.
Yeah, so my company is called Bosco. We are a system strategy and growth and operations agency. So we work with practice owners on the backend. So you think of like company growth or practice growth, you think of marketing and you think of client acquisition, client retention, that sort of thing. But that’s not the only thing that is part of your practice. You have, you know, your operations on the backend. So we,
Brie Chrisman (09:43.31)
really look at practices and see how efficient they’re running, how their company culture works, what their day-to-day looks like, what the CEO’s day-to-day looks like, and really helping practice owners remember that it’s not just a practice, they’re not just a practice owner, they are a CEO, they are a business owner, even if you’re the only person in your practice, you’re still a CEO. And so having…
Being able to help them step into that CEO role and be able to lead and empower their team and also maximize the resources that they already have, whether that’s people or software or, you know, whatever you’re using to help you run your practice on a daily basis.
Yeah, yeah. Yeah, I love that you’re pointing out the whole CEO mindset right from the beginning. And it’s so true, like even solo practice owners, it’s hard to wrap our minds around that identity.
But you don’t really get so out of all the schooling that you go through, how many business classes did you get?
zero
Brie Chrisman (10:43.764)
Exactly. there’s, there’s so many, you know, you look on Instagram or Facebook or just do a quick Google search of, you know, how to run my practice. And there’s, can tell you, there’s probably pages on Google of different people that will tell you how to start practice, how to grow your practice on Instagram or, you know, marketing, networking, whatever. But there’s no one really to tell it to help you.
teach you how to run your practice, how to actually do the things you need to do to run your practice, because that’s a total different beast. And the ones that do still focus on marketing and they’re like, we have operations, but it’s not, it’s not really, you know, it’s not really helpful or it’s DIY. And they just throw a bunch of information at you and it’s not helpful because it’s not translated into non-operations terms. So we’re trying to close that gap.
That’s a, I’m glad that you’re out there. Yeah. I feel like, you know, it’s really exciting to think about marketing and getting people in the door and that kind of thing. But, back end, you know, operation stuff is not, like sexy exactly, you know? And so it’s easy to overlook it and,
So much. We think it’s sexy on our end, that’s just because we’re operations people. But yeah, you’re right. It’s not like the flashy, you know, the revenue income reports that you have on Instagram or, you know, people say, well, I have, I’m completely booked out or I have X amount of clients or we’ve brought in this much, but that’s great. But what does your bottom line look like? Cause you could be bringing in a million dollars in revenue.
but you could still be in the red depending on how you’re running your practice. And something that we’ve really been honing in on with our clients and kind of, you know, constantly, you know, banging our heads against the wall, like, you know, shouting to people is that you, if you keep your expenses low and you keep that bottom line low, then if you lose clients, you’re not in like an crap mode. You’re not like, my gosh, I have to get so many more clients.
Brie Chrisman (12:56.12)
So that just makes your profits even higher. Yeah, I would say that expenses side is more important than there. Obviously, revenue is important. But when push comes to shove, expenses are easier to whittle down than adding more clients. And it takes less time and energy.
Yeah.
Jeremy Sharp (13:17.762)
Yeah, exactly. So just to zoom out a little bit more before we get into the details, what’s a good working definition of operations? I mean, we’ve used the backend stuff, but how would you define operations for anybody who might be unclear?
So yeah, the way that we define operations are the systems like the systems of processes are the strategies that keep your business running smoothly. So for practice owners, you know, that could be your intake process. That could be how you onboard new clinicians. That could be literally a checklist of things that you have to look through every day to send to your biller. It’s essentially your operations are in your processes or anything that’s a repeatable task.
or that has more than one step. You look at it that way. to really, really go down to the nuts and bolts of it. is repeatable tasks and anything that’s, you know, more than one step. So that really is it can be anything in your practice. That’s not somebody that I talked to a couple of months ago. It’s like the front end, like sales in the back end feels like operations. And so anything that’s not bringing in revenue necessarily.
Like truly, you know, clients marketing, things like that are operations, but there’s not to get too into it, but you know, there’s also operations throughout those things as well. But to make it as simplistic as possible operations are the backend that the expense is part of things, things that keep the cog wheels moving.
Right, right. So there’s a lot of overlap with SOPs, I’m guessing, like standard operating procedures.
Brie Chrisman (15:03.436)
We love an SOP.
I do too, a good SOP. Right? So we’re going to focus on client onboarding more than anything, which I love. This is a really important process and it’s also one that a lot of folks are kind of winging and I’m excited to get your perspective having worked with so many practices and my sense is that you actually have some data and a process to.
So good.
Jeremy Sharp (15:35.042)
talk about onboarding and measure onboarding, right? Yeah.
Absolutely. That’s the biggest thing that, and honestly we’ve worked with other clients in other industries as well. just actually had a conversation with someone yesterday that’s a lawyer and he was like, I’m having an issue with following up on contracts. And so it was literally his client onboarding process. we talked about, he’s like, okay, well, when we go to this meeting, was like, okay, back up. How do you get to the meeting? Like, well,
I send them an email and like, okay, well, how did they find you? And so we literally had to back up multiple times. It’s like, that’s where they find you. That’s where it starts. So that’s another thing too, is, you know, the client onboarding process, a lot of people think it’s, just, know, when, when you’re sending paperwork and then you schedule them for the first appointment, like, no, it starts way back in, it really starts like when the marketing ends almost like that’s where it gets taken in.
Yeah, yeah, let’s define that. So what would you say is the first step in the onboarding process? And then where do we go from there? Like, what are the major steps in the onboarding process?
Inquiry, so, and without going into like itty bitty details, but inquiry, consult, confirming that they are going to onboard, paperwork, scheduling for session, going through for session. And then of course that goes into clinical and then going through, you know, making sure that they stay onboarded so that way they’re not churning out at.
Brie Chrisman (17:10.691)
Some people do it after six appointments, some do after eight. What is your turn rate usually?
Well, mean, we’re lucky, you know, just doing testing, there’s really no turn. Yeah. Once people get in for the intake, they see the process through. That’s true. Which is great.
Yeah, that’s true. get that full completion process. Yeah. Yeah. So that’s really it. know, inquiry, consult, typically follow ups, paperwork, confirming, onboarding paperwork, scheduling that first appointment. And then of course, you know, with testing and stuff, I know there’s multiple appointments and all of that, but that’s, I think that transitions into actual, you know, existing clients and clinical and all of that.
Right, right. Yes. So I wonder if we maybe walk through each of those steps in the process and I would love to hear, gosh, how do we organize this? Like things that you’re finding that work at each stage and things that are not working or kind of pitfalls that people are running into at each stage. How about that?
Yeah, absolutely. So in the inquiry stage, we see a lot of people that just have their consults directly on their website, which I do think you should absolutely have the. Smallest barrier to entry to just get people in the door. So obviously, you know, we I had a client several years ago that didn’t was nervous about turning online scheduling on an EHR. Like, promise you, it will make your life so much easier.
Brie Chrisman (18:46.784)
and she hasn’t looked back since. will say though that we find doing some sort of inquiry form before scheduling that consult is super beneficial for screening those potential clients. So, you know, if they say that they have a specific insurance that you don’t take, that’s not wasting their time or your time.
So you can reach out to them and say, hey, unfortunately, I don’t take your insurance. I’m happy to see you out of network, but here’s what it is. And then that’s, you don’t have to waste that 15 minute slot, especially when you’re crazy busy. Also things, if somebody needs something that’s like for, specifically a lot of, we work with a lot of social workers and so they get a lot of referrals for higher, like severe cases. And so a lot of those.
you know, really need to be more inpatient or they need to see a specialist. And so that’s not something that the clinicians that I work with are, you know, are doing right now. So that’s another thing, because, know, that’s especially we get a lot of for this one client that I work with, we get a lot of referrals for like teenagers. And so it’s their parents and they’re just getting out of an inpatient center and they’re having to do, you know, outpatient care. And so
you know, it’s stressful for the family. And so the more, the faster that we can get them through that process and saying like, hey, this is not us, but here are some referrals for people that we know do really well. That’s always great. And then you get the good rapport and then you, you know, still get referrals from people because you’re, you know, you’re going above and beyond, even though you’re not doing that consult. So having that inquiry form is definitely a really good way to screen people.
we, we had a client last year that was nervous about clients and she, she wanted more. She was nervous about, you know, she hadn’t had a client on board in a little bit and she wanted to fill her caseload. And she’s like, I think the barrier to entry is too high. So I’m going to take the inquiry form off and just go straight to consult. And we, we, along with someone else on her team, advised her, that’s probably not a good idea, but you know, if you really want to do it, we’ll try it for 30 days.
Brie Chrisman (21:09.164)
And it caused so many issues and she had way more no shows for consults. And she had a lot more, there’s a lot more work on the backend because there wasn’t a way for us, like us, like part of my team as the admin support. cause she’s one of our admin support clients that we can’t see when she was getting consults. And so then she was having to do all the back and forth and it was creating more work.
And so it just it was just a cascade of things that just made everything worse. And so she’s like, yeah, no, that was a bad idea. We’re going to
Yeah, bring back the form. Yeah. Let me get super granular here. I mean, when you say an inquiry form, is this typically just a form that people fill out on the website? Clients come to the website, they fill out the form, it goes, they submit it and it goes to either the psychologist or the admin person.
So, yeah.
Brie Chrisman (22:09.038)
Yeah, so what we have, the process that we’ve created over four and a half years that works really, really well is having a form. Typically it’s a Google form and we have a BA with Google for all of our clients. We make sure they have that, which is really helpful. But we have, you you click the link to schedule an appointment and it goes straight to this Google form. And then from there, it will put on the confirmation page. Thank you for filling out the form.
Click here to schedule your appointment. And so that will automatically allow them to go and schedule their console. So that way it’s a smooth process. And then of course with Google Forms, it comes into a spreadsheet and then we have an email that goes directly to the admin support inbox that says that someone filled out the form. And so then we can go in and check and see one, if they’re right fit and two, if they actually scheduled their console in simple practice, because you know, let’s be honest, most, a lot of people
We’ll just skip that step and just close it out really fast. then we, but because we have those checks in place, we’re able to follow up with them and say, Hey, thanks for filling out the form. We noticed that you didn’t schedule your console. Here’s the link. And so that way we’re able to do that a lot faster. but the form, since we’re getting granular, a lot of times the form is, you know, typical contact information, first and last name, email address, phone number, age. So that way we know if they’re a minor or not.
Where are you located? Because a lot of our clients are licensed in multiple states. Because that’s a screener question. If they’re in a different state, then we can automatically tell them we’re not licensed there. There’s session location preference. So whether it’s in person or virtual, which therapists they’re looking to have a consult with, any details that might be helpful for the consult, and then payment preferences. So if it’s out of pocket, out of network,
Some of the client clinicians that we have are in network. So we’ll put like their name and what insurance panel they’re in network with. So that way people know like, hey, so and so with Aetna. And so that way they can see who has what. Also ask their primary health insurance and just have a… These are questions that we’ve added throughout the years because it’s like we’ve come into issues where people are like, well, I have Aetna.
Brie Chrisman (24:36.632)
but then don’t realize that it’s their secondary and then it just, you know, causes a world of problems. And I’m sure you’ve run into that. So, you know, having a note on there, it’s like, heads up, this has to be your primary insurance. Another thing we’ve come across is third party billing. you know, those 18, 19, 20 year olds, 25 year olds, 30 year olds that their parents or someone, grandparent or something, someone is paying for their care.
Sure.
Brie Chrisman (25:05.806)
We’ve run into situations in the past with clients that a 20-year-old was utilizing her grandma’s credit card. And so, and the grandma disputed the charges on her credit card. And so we ran into this whole thing. So now we have a process of third party billing where we, you know, have an authorization so that way we can get, you know, basically release of information for HIPAA. And then we have that person sign all the forms as well. So they know like, hey, you’re on the hook for payment.
Gotcha.
So things like that, but it’s it’s and of course, like, how did you find us? What’s your communication preference? Things like that. So, yeah, it’s a lot of screener questions that we’ve just learned because from experience that, hey, we need to know this information up front so that way we don’t get hit in the back end of like, this is this is going to be an issue. Sure. So all of that stuff can be done on the front end, which is great.
Sure.
Jeremy Sharp (26:06.424)
That is great. Yeah. And I’m guessing there are probably some folks out there who are like, my gosh, what did she even just say? Like you submit a form, it goes to a spreadsheet, then it notifies somebody. just to, it’s easy. Just trust. Just trust. It’s easy. This takes like five minutes to set up. It’s.
Yes, Google Forms are super easy to set up. And then you literally just click a button that says like export to spreadsheet and it automatically pulls it in for you. It’s a piece of cake.
Yes, yes, great.
And if you need help, just call us.
Sure, yeah, people can help. There are people to help.
Brie Chrisman (26:41.934)
Asking for help is not a bad thing.
Right. Right. OK. So that’s kind of the inquiry phase. Where do we go next?
So obviously if they didn’t schedule their console, or I will back up a little bit, if someone reaches out from like Psych Today, My Wellbeing, on Alma, Headway, all of the places, or just emails directly on the website, sending emails with the form. So we have email templates that we have saved in Google that you can literally click buttons and just pop it right in. So thank you for inquiring.
We’d love to schedule a 15 minute consult. Here’s what to expect. Here’s the link to fill out the form and then letting them know you will fill out the form and then be prompted to schedule your call. So that way they know to look for that link. And then we send our policy is to send three, depending on what stage we’re in, like three follow-up emails after that initial one. Cause we do find that if someone is going to respond, they will typically respond by the third.
email.
Jeremy Sharp (27:48.15)
Okay. I just want to highlight that because this is a big question. People ask us a lot and a lot of different circumstances. Like how many times do I reach out to someone before I let it go? And you’re saying three responses. Like is this coming from some kind of data? Like that, you know, people maybe don’t respond to the first one, but they will respond by the third one somehow.
data that we have collected over the years and it’s not just therapy, it’s, you know, ad sales, it’s, you know, asking for sponsorships. It’s any time that you’re trying to convince someone. The thing is, you know, at the end of the day, therapy is a business. mean, yeah, that’s very black and white, but you are at you are technically selling something. And so it’s really the same process.
whether you’re selling ads, selling therapy, jewelry, not jewelry, but like services that it really does. Because a lot of people are like, that looks interesting. I’m just going to leave it in my inbox for a while and I’ll just get to it later. Yes. And then the second email like, right. I need to do that. And then the third email like, shoot, I actually need to do that. Like they’re they’re not going to leave me alone. They’re reminding me. And a lot of times people are like, thank you.
Thank you so much. I’m going to schedule the consult. And then typically we send another one just, you know, just in case that it goes into spam. And a lot of times if you send multiple emails, especially if it’s on the same thread, it will kick you out of the spam folder into the main inbox. So that’s another reason why we do it. Typically the second or third email, it will kick you out of the inbox in the spam folder. So because, you know, that happens.
It does happen. Yeah. I just want to highlight that. Like just to say that again, that I think a lot of us, or at least a lot of my consulting clients, there’s a fear of like pestering people or bothering people, being annoying, being salesy, being whatever. But the way you frame it makes a lot of sense. And that resonates with me personally. I mean, I get so many emails and I’m like, that is interesting. And then everything in my life happens and I forget about it. And then
Brie Chrisman (29:37.356)
So.
Jeremy Sharp (30:04.302)
Like a couple more reminders. like, okay, okay, like good. Yes, I need to.
It finally bumps up to the top of the list once you get that third follow up. And another thing too is you’re not cold calling people. Like these are people that have sent you an inquiry of some kind. They’re a warm lead. So you are doing your due diligence to follow up with them because they reached out to you for therapy, for testing, whatever you are doing. You are, you know, you are supporting them.
Yeah, yeah, exactly.
Especially with, you know, therapy is asking for help is hard. And so people might not be ready the first time you send it. And then it’s just sitting there in box and like, do I don’t I, I don’t know. And then, you know, finally, and that it shows that you care to honestly, it’s not a pester. It’s the fact that you really want to help them.
Yes, nice reframe.
Brie Chrisman (30:58.69)
Cause there’s, will tell you in my personal therapy experience, the amount of therapists that I’ve reached out to that don’t even email me back is insane. It is. Like, do you not want clients? And if you don’t great, then put that on your Psych Today profile that you’re not accepting your clients. Or, know, just email me back. So having a dedicated, yeah, just being dedicated and just, you know,
I hear that so often. Yeah.
Mm-hmm
Brie Chrisman (31:26.752)
treating people with a modicum of respect.
Yeah. Okay. After that, obviously we have the inquiry we have. Once they get that, you know, that email, they go through the intake process or they go through the inquiry process where they fill out the form, they schedule their consult. If they schedule a consult, like three weeks or more out, we typically reach out to them and say, Hey, did you want to, you know, maybe the clinicians on vacation or something and but they have spots open, you know, on their
you know, we could manually schedule. And so we always ask them, Hey, do you want to get in earlier? And eight times out of 10, they say yes. And then it just shows that again, it shows that you care and it’s throughout the whole process, you’ll kind of see as we’re going through this, that every single step is creating a great experience for the client. And so if they want to feel safe with their therapist, that needs to be company wide.
It can’t just be while they’re in session. creating that supportive net for them and making sure that they know that we’ve got their back is huge. And that starts at the first instance of communication.
that you mentioned them.
Brie Chrisman (32:45.922)
Yeah. So consult happens. Typically all our clients do 15 minute consults. And then we have for I’m using roughly the basically the same client for just as a preface. For a lot of my examples, I’m using the same client because she’s been a client since I opened my company in July and she of 2020 and she came on September 2020 and she’s still around.
So I’ve literally watched her and she started her company in March 2020. So I’ve literally been there for pretty much the whole thing. And she’s, you know, she’s built a successful practice in New York City. And so she’s and it’s all the things that I’ve like, she’s my guinea pig. So anytime I want to test a new software, I’m like, hey, you up for it? And she’s like, yeah, absolutely. Nice. So she’s like pioneering the operations stuff for us.
I love that. that reminds me actually, when you mentioned software, mean, up to this point, there is, I’m just curious if you’re using any software outside of Google workspace. I mean, there’s a lot of chatter about like CRMs and how do we keep track of this? You know, is it anything like that or are we just keeping it simple?
Let’s take a break to hear from a featured partner. Y’all know that I love Therapy Notes, but I am not the only one. They have a 4.9 out of 5 star rating on TrustPilot.com and Google, which makes them the number one rated electronic health record system available for mental health folks today. They make billing, scheduling, note taking, and telehealth all incredibly easy. They also offer custom forms that you can send through the portal.
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Jeremy Sharp (34:53.816)
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To this point, I’m just using Google. Gmail, if you’re using Microsoft, run away really fast and get on Google. Please. Google Sheets. Yeah, Gmail, Google Sheets, and Google Forms so far. And then whatever your website platform is. Which could be like Weebly. It doesn’t have to be perfect.
Mm-hmm.
can even create like a Google site if you really wanted to. Okay, so console happens and then with our star client, what we do is have the clinician has an email template that they send. It’s a follow-up email. if, obviously if the client says like hard no, can’t do it, they’ll send out still send a follow-up email, like thank you so much for your time. And they CC the admin team.
Brie Chrisman (36:35.458)
So the admin team knows what to do next. And so they’ll, you know, offboard them from the EHR, they’ll remove them from, and we always put a little note, we use simple practice for most of our clients. And we’ll put a little, like an admin note on there saying like, we’ll not onboard after console. So that way when we go back through inactive clients, we can see like, who is this person? Why didn’t they not onboard? And then we know.
But the people that are like thinking about it or gung-ho about moving forward, the follow-up email will, you know, they’ll of course be really warm and say, you know, thank you for, we’re really excited to work with you. And then we’ll specify some information. So it’s like you were interested in having in-person sessions. We were looking at Wednesdays at 3 p.m. bi-weekly.
you are my full rate or my rate is XYZ or you are looking to use your in-network benefits with Aetna. And so it has and like especially like the third party billing as well. You have another person that’s going to be in charge of billing. And so what that does is confirms everything in writing from the console, which is really important.
and then also just notifies the admin team so that the clinician doesn’t have to send the email to the client and then send another email to the admin team, letting them know what’s going on. So then we take, like the admin team takes it from there and we’ll respond to within like, usually we give them like a day or two and say, you know, if they haven’t responded yet, we’ll follow up and say, Hey, I’m so glad that you and so-and-so connected, please let us know how we can support you in onboarding or whatever. So.
From there, if they say yes, I’d like to onboard, we get them scheduled for their appointment first, because we have been bitten in the butt with that. I’m sure you have where you send a bunch of paperwork and then they just ghost and don’t actually schedule an appointment. And then that’s more work for you. So we found, get them on the schedule for that first appointment and then send all the paperwork. And we have an onboarding email template that says,
Brie Chrisman (38:50.222)
You’ll be getting an email from simple practices, your client portal, yada yada, you have a bunch of paperwork, fill it out 24 hours before. If they’re for this practice specifically is my example, they have use Alma for their in network. So like you’ll also be getting an email from Alma. This is where we submit claims and you know, you’ll get all the information from that. So that way they know what to expect, because that’s also you know, if you’re just getting random emails for with a bunch of paperwork, you’re like,
Like, what is this? This so overwhelming. Of course, of course. And so letting the client know what to expect is so important too. And then, you know, making sure that you’re open for questions and everything like that. If they don’t respond right away, we send typically four follow ups for that because they’re already more than a warm lead. You know, they’ve already gone through the con. They’ve gone through all this whole process and they’ve actually had the console and a lot of times
the clinician will be like, well, I don’t know why they didn’t respond because they were like, yes, let’s do it in the call. Right. They just kind of ghost. which, you happens.
Yeah. Right here? I’m curious why the clinician wouldn’t go ahead and book the appointment from the consult. Like why that extra friction, you know, to CC the admin team and then have them follow up.
So that is definitely a personal choice depending on how your practice is set up. With this practice specifically, the way that the practice owner wanted it set up, that the clinicians solely can focus on clinical. They do a lot of their rescheduling, but admin take, it’s basically, she set it up as a boutique practice and it’s really to focus on
Brie Chrisman (40:41.506)
the therapy and so the admin support team really takes care of everything else. They take care of scheduling, rescheduling, cancel those needed. We really make sure there’s a boundary between anything clinical and anything admin.
Gotcha. So I maybe asking for those solo practitioners out there or others who might want to do a different. Do you see any downside to just booking straight into the appointment in the console?
No, as long as you have clear communication with whoever, obviously if you’re a solopreneur or a solo practitioner and you are doing everything yourself, then yeah, absolutely. Go ahead while you’re on the console call with them, book it, send the paperwork, you know, just do it right on the call. I think that’s, it’ll take you two minutes. So they’re yeah, I’m sending it to you right now. You should expect it in your inbox and just make sure, and just make sure you give a timeline of, you know, please fill it out, you know, 24 hours prior.
or 12 hours prior or whatever, just so you can look it over, know, make sure there’s no outstanding, you know, weird things going on. If you have an admin support person of any kind, whether it’s a VA, you know, a whole scheduling team, whatever, if you want them to send the paperwork, you just have to make sure you have clear, open lines of communication. So if you are booking the appointment or booking the recurring appointment, you know, recurring appointment series, letting them know, you know, hey,
this person’s ago, I booked them for the first appointment, can you do the rest? And so that way you just, you know, just communicate because that’s, that’s where we find we’re like, you know, you have the console and you go right into the next session and then forget to tell the admin team and then no one sends the paperwork and then it’s appointment time or like the next day. It’s like, why didn’t you send the paperwork? Well, cause you didn’t tell me to. So it’s really just about that open, transparent communication too.
Jeremy Sharp (42:32.226)
Got it. Great.
So from there, we make sure we keep a close eye on paperwork, make sure we’re following up. Typically about three days, three or four days prior to the appointment, the first appointment, if their paperwork isn’t done, we’ll nudge them and say, hey, we noticed you haven’t done it. Do you have any questions? And just keeping emails in a way that’s
Not like, hey, you haven’t done your paperwork yet. You have to get it done. It’s like, hey, do you have any questions? We notice that you haven’t finished it. Anything we can support you on. And just reframing it in a way that is supportive to them, but also like, hey, get your stuff done. Yeah. And then they have their onboarding. then from there, it’s really, know, it’s clinician completely takes over. And then
Right, right.
Brie Chrisman (43:28.654)
If they need anything with billing or scheduling, just, you know, we have great communication.
So let me ask you a question about the paperwork. Have you found anything? Because there’s a lot of, again, debate about this. And people ask this question a lot, whether it’s better to have basically like how much paperwork is too much. I feel like we have a million forms. tried to simplify them, but it’s a lot. Our demographic form is pretty long. So there’s kind of a question of, yeah, do you do a longer demographic form or?
you know, do a shorter and then do more of them. The intake, what have you found just in working with a bunch of practices in terms of people filling out paperwork?
I so I’m going to come at this question from a perspective of as an operations person working with practices and also a person that has been to therapy and that has filled out a million and a half forms for my child who is also in, you know, play therapy, OT, speech, physical therapy. I’ve done all of the intake process. I’ve seen them all. I will say
See ya
Brie Chrisman (44:43.66)
that I think that having when you’re talking about demographics or like intake questionnaires, having a lot of the quality of your paperwork I think is also important. So from that point of looking at if you have a lot of open-ended questions that can seem super, super overwhelming versus if there’s a way instead of like
do you smoke? You could say instead of having an open ended question, you could just have a, you know, a drop down or both, you know, multiple choice question. And that makes it feel less overwhelming. And so being able to make it that something like that makes it feel a lot quicker too, and a lot more manageable. As far as, and like I say that coming from my son, try to,
tried ABA therapy earlier this year, or I guess in 2024. And with ABA, you have to fill out all the forms ahead of time before you’re on boarded or before you even have a consult because they have to get you on the waitlist and they have to know enough information about you. I had to fill out, it would take me like 15 minutes to fill out these intake forms. And of course they’re all super negative because you have to, you know, be like, what’s wrong with your child? it’s super-
I applied to like 20 different wait lists and it took me days to fill those out. However, I will say the ones that were a lot easier were the ones that just had like those multiple choice questions and things like that. I will say from a business owner standpoint, I do not, how do I say this right? From a business owner standpoint,
As whatever amount of paperwork gets you the information you need and covers you legally is the number of documents that you need.
Brie Chrisman (46:50.606)
So we’ve had, so I have a client who it’s actually, her husband’s a lawyer. so he, like she’s like, I, and she’s paranoid about being ever audited or anything, like, she’s like, I don’t wanna be that person on the news that has the horrible malpractice and all of it. She’s like, I’m not gonna be the person on the news. I’m going to be locked in so tight on legal.
You know, we have all of our policies in place. No one is going to be able to dispute charges like we we are locked in. And also a lot of information for clinicians and there it’s 17 forms that go out for onboarding. But it’s you know, there’s the DOS screener, the GAD seven, their PHQ. Like those are three of them. there’s but there’s like a therapeutic process understanding confidentiality, the HIPAA, know, HIPAA policy, things like that. There’s a covid waiver because that’s required in New York.
So all of the, mean, that’s a bunch right there that would take you five minutes to sign. So it seems like a lot, but it’s like, it’s a paragraph I have to read and sign. Okay, great. So it’s, and I feel like that a lot of people put all of that on one, on like one document and it’s like 15 pages. That almost feels more overwhelming than 17 documents sometimes. I guess it depends on the person, but I will say that from
almost the start of her company, because I’ve been there for four and half years. We’ve had three people ever that said, I cannot do this, these documents, it’s too much. That’s three people out of four years and they averaged between 150 and 200 clients on their roster at a time. So, mean, we’re consistently onboarding like 10 to 15 people or 10, I guess, 10 people per month. I mean, it’s…
Got it.
Brie Chrisman (48:43.244)
Yeah, it’s a very, very small number. And you have to remember that you are a business owner. You know, you’re a therapist, but also a business owner. So the last thing you want is having someone come after you for some reason, probably no fault of your own, of someone, you know, even a, you know, an ex of a client that is, you know, abusive or, you know, someone who’s mad about their
daughter taking their credit card and then trying to sue you because things like that, if you can cover yourself, then you’re not going to lose your livelihood. You’re not going to lose your reputation. You’re not going to lose your license. And so it really is, I think the right answer is whatever documents, however many documents you need to get the information you need for your client and to cover yourself legally and financially is what you need. It’s kind of a very diplomatic answer.
Yeah, super diplomatic. It’s okay though. It’s okay. Some of it just depends.
Yeah. I mean, yeah, it depends. And there’s some that, you know, I think there’s one therapist that I went to that like didn’t have any, I didn’t even sign a hippo form. She’s like, just let’s do therapy. Here we go.
we go. Yeah. You cool? Yeah, I’m cool.
Brie Chrisman (50:02.994)
If you want to burn down your company and just do paper calendar and stuff, I do what you want to
That’s a good point. Well, even this component of trying to eliminate open-ended questions from our forms, I get it. mean, from a clinical standpoint, they’re helpful, but from a consumer standpoint, yeah.
There’s definitely some that you need, but there are some that can be multiple choice or like a multiple choice with a short answer, depending on like what. So we actually just redid all of the intake forms for the same client. I went through all of her forms in November and audited all of them before we did new year paperwork. And the intake forms, a lot of them were where I would be able to combine
like three questions into one where I can do one question and then for each answer, it could be like you click yes and then it pulls up another little box. It’s like, okay, tell me more information here.
Yeah. Yeah, even having an eye towards simplicity, I think you’re right. There’s a lot that we could combine. There’s some fluff in there. know, we’re always trying to.
Brie Chrisman (51:12.972)
Honestly, it even comes down to, you know, formatting. little, you know, putting those little line spacers and headers and sections and bolding, italicizing, all of that. I mean, it just breaks it up. So it doesn’t seem as overwhelming too.
Yes.
Jeremy Sharp (51:30.572)
Yep, it goes a long way.
the psychology of paperwork too.
Now that would be a great podcast.
I don’t think I’m qualified for that one.
If you find me someone, send them my address. So big question, know, lot of practices I think are collecting credit cards upfront upon booking. Are there any, but then there are many, know, who say, you know, we don’t do that, we’re not going to do that. Any like best practices around that or ways you found to sort of ease that process?
Brie Chrisman (51:42.506)
I will. I will.
Brie Chrisman (52:03.986)
I have a very polar answer to this. I, this might be an unpopular opinion. I don’t know. I do not like when someone asks for a credit card before a free console. I feel like it feels overwhelming. It feels like, my gosh, why do they need my credit card? I haven’t even decided if I’m going to go with this person. You know, I’m doing concerts with a couple of different people.
Okay.
Brie Chrisman (52:31.798)
And then they’re going to have my credit card information, which I’m not, you know, super aggressive with. But then I’m like, it’s just one more thing I’m going to have to delete out of their system and, all of that. So I, from a personal standpoint, but also from a business standpoint, I have seen where people don’t go through with the paperwork for the console. It’s hard to get people to fill out paperwork for a console, to be, to be frank. And.
Also, I have seen where people no show on consults because they don’t want to submit that information. Now, when it comes to actually onboarding and scheduling that first appointment, heck yeah, make sure you have that credit card before. And I even, you know, if they don’t have it before, we typically tell them, you know, we have to reschedule your first appointment because we need all of your paperwork done.
That makes sense.
Yeah, that’s kind of great. Yeah. Yeah. I mean, and feel free to disagree with me, but I feel like it’s. It’s. Kind of, you know. Sorry, I have way too many thoughts running through my head right now.
Getting people in for a consult for therapy is already tough. know, have to, people have to be ready to go to therapy. And so then I feel like, you know, asking them to fill out a Democrat form is one thing, but asking them to like put their money where their mouth is and put the credit card on file for a free consult just seems like it’s too much of a barrier to entry.
Jeremy Sharp (54:03.918)
Yeah, that’s fair. I’m totally with you and I should have clarified. Yeah, I don’t know that we’re trying to do a credit card before the consult, but before booking an actual appointment.
100 % yeah. yeah, we typically, so, because we booked the first appointment before we send paperwork, a lot of the time, we will say you have to have every like your everything done 24 hours prior to the first appointment. And then if it’s not, we reschedule that appointment out, or we will say, actually, I think we’ve gone to the policy where, okay, once you fill out your paperwork, we will schedule that first appointment. And so that way, you know, they get
They get one like buffer where like, we trust you to do the paperwork. And then if they don’t do it, we’re like, no, you have to show us that we can trust you.
Totally. you go. Yeah. Yeah. So maybe we start to wrap up with a question that is almost, I’m not sure how to almost said like on the flip side or like an opposite problem, but it’s all part of the deal. And that question is how do we work with, um, just a high volume of
Exactly.
Jeremy Sharp (55:20.106)
inquiries. So I’m guessing you work with some practices and you know this full transparency is a very selfless question because this is our main problem. That’s really why I do these podcasts is just to answer my own questions. Why not? question is like how do you deal with really high volume of inquiries? Like I cannot just keep hiring admin staff to create more and more consult appointments.
You know or answer more phone calls So yeah, I’m curious how you think about a problem like that where you’re getting like way more inquiries than you have the time in a week to Yeah deal with
That is where I would bring a CRM in. So customer relationship management. I will say I have used a lot of CRMs in my day. And before I started my company, I was in project management and event management. And so I’ve seen all of the project management tools, all of the CRMs. There’s one that I have recently discovered that I absolutely love and it’s therapist specific. It’s Wise Practice. They just launched in
Brie Chrisman (56:25.502)
April, like they soft launched in April and then they fully launched in July and they’ve done like 20 iterations since then. It’s fantastic and that’s coming from an operations person. And if you need it, I’ll send you my affiliate link.
Hey, I would love to check it out.
Yeah. So the thing that I love about a CRM like wise practice is that it has workflows and it has where so a workflow for anybody that doesn’t know what that is, is basically an automated process that can do the steps for you. So what we can do and for the client that I’ve been using for my examples, we used to have Zendesk for, for like support tickets and things like that, where we can automate our followups, which was really great.
But Zendesk their business model is terrible and their customer service is terrible and they’re super expensive. So I really do not recommend them. However something like wise practice You can have that communication where you connect your it’s a two-way sync with your Gmail. It’s fully HIPAA compliant It is you can do your workflows you can do even documents through there and there’s other opportunities where if like if you do webinars and courses for other therapists you can like
using like kajabi or something like that, you can pull all of that in there. Jeremy’s like, my gosh, what is this?
Jeremy Sharp (57:50.08)
Yeah, seriously. Yeah. I’m going to have to end our podcast now and go check out practice. Sorry, sorry.
Oh, that’s okay. As long as you use my affiliate code. I’m just kidding. No, so the cool thing that I’m excited to try it out with in typical business owner fashion, like, yeah, I really want to build one out to test it out and I don’t have time. But that’s my goal for, you know, Q1 of 2025 is to test it out. But what we can do with it is have the inquiry form in
Ha ha
Brie Chrisman (58:24.17)
wise practice and once somebody submits it, we can send them like a thank you email and send a reminder to schedule the console automatically. And then we can send reminder emails automatically if you know, it’s like an if then, you know, if they haven’t responded by this day, then send out this follow up and things like that. And also the really cool thing about this is that and I’m sure you’re aware of this, but like, you know, some people email, some people text, some people call and you have to search
like, did this person send me anything? And you have to search in 10 different places and like secure messaging. In wise practice, you can take all of the texting, the calling and the emailing and it’s like all together in the, in the client’s contact information. So you can see when they texted, when they emailed all in one spot, which is very, very cool. And it just, it, even that extra two minutes or five minutes that it takes you to
go on the three different platforms you need to check. It’s all right there.
It adds up. Fantastic. Well, yeah, I am going to do some homework on wise practice.
Yes, definitely do. If have any questions, let me know.
Jeremy Sharp (59:37.282)
Great, great. This has been awesome. Yeah, I love just doing a deep dive into this kind of one aspect of practice management. It is, it is. Maybe the most important.
important one.
One thing we didn’t talk about too is that the reason why you want to streamline your process is that each person, like I guess, so, because I feel like somebody listening to this episode will be like, okay, that’s great, but like, why am I doing all of this? That just seems like way too much work. And so the reason you want to do this is one, making sure that every client has the same experience. And two,
If each client has a different experience, how are you tracking your numbers, your KPIs, your key performance indicators? How are you tracking where people are falling off in the process? So if you’re not onboarding people, you can look at if you have the process in a standard operating procedure, so written down and everybody follows the exact same process every single time, are they falling off after the inquiry form? Okay, are you sending follow ups?
Are they falling off after the consult? Okay, what does your consult look like? Maybe do a role play and see, okay, what’s going on in your consult? Are you asking the right questions? Are you getting good vibe? And also making sure that they’re the right client for you, because it’s both ways. It’s an interview both ways. And then looking at, okay, well, you sent the consult follow-up. You scheduled their first appointment. Why are they ghosting and not doing paperwork? Do we need to send more follow-ups?
Brie Chrisman (01:01:13.346)
Why did they not show up for their first appointment? know, things like that. And so you can really see where your issues lie and be able to fix those. And that way just, and again, you’re caring for your client all the way through the process, regardless if it’s in session or out of session.
Yeah, yeah, I totally agree. I’ve said on the podcast many times before that a lot of anxiety can be solved with math. And this is just another extension of that. know, you have that. Math and communication, there we go. Yeah, that’s so true though. Like tracking all these things gives you lot of insight into what’s not working. Yeah, or what is working.
Communication.
Brie Chrisman (01:01:52.322)
Yeah, absolutely.
Yes, exactly. Because that’s important too. You got to celebrate those wins.
Absolutely. Yes. Well, this has been awesome. What can people do if they want to reach out or learn more about you? What’s the best way to do that?
Yeah, if you want to learn more about us, our website is chock full of information. It’s heybosco.com. You can email us at hello at heybosco.com. We’re on Instagram dropping knowledge. We send out a couple of newsletters a month with, you know, tips and tricks and knowledge of how you can support yourself and how to, you know, create efficiencies and just make your life a little easier. So sign up for that too.
Yeah, sweet. All that will be in the show notes. Of course, go check it out.
Brie Chrisman (01:02:42.35)
Oh, we also have in the show notes will be a freebie for anybody listening. is a just a quick PDF of client onboarding paperwork checklist. So you can really look at what you need for demographics, for therapeutic processes, for billing and all of that. So that way you can really audit what you have and then see if you need anything else.
Love it. Love it. And like you said, we’ll make sure to put that in the show notes. So I’m going to close with the most important question of this whole conversation, which is, you a Clemson or South Carolina fan?
Neither, I am a Hokies fan.
Brie Chrisman (01:03:26.37)
Delete the whole episode. Go Hokies, all the way.
Okay. Seriously, appreciate your time. This is fun. Thanks.
Thank you. was great. Great conversation. Appreciate it, Jeremy.
Alright y’all, thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes, so make sure to check those out. If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes or Spotify or wherever you listen to your podcasts. And if you’re a practice owner or aspiring practice owner,
I’d invite you to check out the Testing Psychologist Mastermind groups. I have mastermind groups at every stage of practice development, beginner, intermediate, and advanced. We have homework, have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, can check out the details at thetestingpsychologist.com slash consulting.
Jeremy Sharp (01:04:39.746)
You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.
Jeremy Sharp (01:04:52.27)
you
Jeremy Sharp (01:05:05.016)
The information contained in this podcast and on the testing psychologist website are intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional psychological, psychiatric or medical advice, diagnosis or treatment. Please note that no doctor-patient relationship is formed here. And similarly, no supervisory or consultative relationship is formed between
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