[00:00:00] Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.
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/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. Visit parinc.com/neo.
Hey, everyone. I am back today with a business episode. I’m talking with Brie Chrisman from Boss Co. [00:01:00] She’s the founder and CEO Boss Co, 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 a unique niche. And like I said 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. When I say onboarding, I mean the whole process of getting clients into your practice and into their first appointment. You might think, okay, there’s not a whole lot to say about that, but as we dive into the episode, [00:02:00] that will become clear that there is 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. 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? All kinds of questions like that. So if you 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.
Before we get to the conversation, we are coming down to the wire as far as openings in my mastermind coaching groups, which start 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 [00:03:00] 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/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 Brie Chrisman.
Brie, hey, welcome to the podcast.
Brie: Hey, thank you, Dr. Jeremy. I appreciate it.
Dr. Sharp: Dr. Jeremy.
Brie: Dr. Jeremy.
Dr. Sharp: That’s really nice. I’ll take it. I usually just do Jeremy and any opportunity to bring in …
Brie: Give the credit where credit’s due. I’ll do Jeremy the rest of the podcast, though.
Dr. Sharp: That’s fair. That was my moment of glory here. Thanks. I’m excited to chat with you for many reasons. [00:04:00] One is because you live 10 minutes from where I grew up in the small town area of South Carolina, which is totally crazy. We figured that out and I feel a connection with you.
Brie: It is such a small world.
Dr. Sharp: Yeah, there really is. So there’s that, but then you’re also going to talk with me about operations and onboarding in our practices, and that’s also a topic that a lot of us need some help with. So I’m glad that you’re here. Thanks for being here.
Brie: Thanks for inviting me. I was excited that we talked what month or two ago about what it would look like for me to come on the podcast, especially not being a therapist. And so being able to talk about something that we’re really passionate about, and also we can help therapists with is really great.
Dr. Sharp: Yeah. We’re always grateful for you folks out there who choose to make a career out of helping us. That’s maybe a good place to start. I would love to know [00:05:00] why this is important. Why pick mental health psychologists or therapists for your target audience?
Brie: It was 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. Of course, those referrals came from therapists and then we’re therapists. And then 90% of our clientele were therapists.
And so we dug deep and figured out, okay, where do we want this to go? 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, and it was great. I wasn’t called to be a therapist. I was called to be an operations person. This is my way of [00:06:00] being able to make an impact.
But why it’s important to us, this world that we live in is so chaotic and we’re getting bombarded all the time with so many situations, issues, and things. As a practice owner, there are 8,500 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 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, 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 trickles down to their families, their clients, and so on and [00:07:00] so forth. So it’s our little rock in the pond of how we can help mental health.
Dr. Sharp: I love that. I think we forget about that. As practice owners, I’m speaking for myself, it’s easy to take things on, keep going and end up maybe … I don’t know if I’d use the word burnout as something that has happened but even people have burnout as the rock bottom place or even leading up to that, like if you’re at 8/9 out of 10, you don’t have to be at a 10 out of 10 for it to affect your work, your employees and your clients.
Brie: You don’t have to be a 5 out of 10. A lot of therapists that we work with are at that, they’ve hit that proverbial wall where they’re like, I [00:08:00] just want to burn it down and go back to being a solo provider with no EHR, just doing things on Google Docs and 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 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 one of those three things, and the solution is the same for every single one.
Dr. Sharp: Oh, that sounds really nice. We’re going to talk about that.
Brie: Yeah, it’s exciting.
Dr. Sharp: I’ve experienced all of those things at different points. 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 a paper calendar, [00:09:00] this might be for you.
Just tell people what your company does. It’s probably nice to set the stage and then we’ll go a little bit deeper into this whole idea of operations and onboarding.
Brie: My company is called Boss Co. We are a system strategy, growth and operations agency. We work with practice owners on the back end. So you think of 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 your operations on the back end.
So we look at practices and see how efficient they’re running, how their company culture works, what the CEO’s day-to-day looks like, and helping practice owners remember that it’s not just a practice. They’re [00:10:00] 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 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 whatever you’re using to help you run your practice on a daily basis.
Dr. Sharp: I love that you’re pointing out the whole CEO mindset right from the beginning. And it’s so true. Even solo practice owners, it’s hard to wrap our minds around that identity.
Brie: So out of all the schooling that you go through, how many business classes did you get?
Dr. Sharp: Zero.
Brie: Exactly. You look on Instagram or Facebook or just do a quick Google search of how to run my practice. I can tell you, there’s probably pages on Google of different people that will tell you how to [00:11:00] start a practice, how to grow your practice on Instagram or marketing, networking, whatever but there’s no one to 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 and they’re like, we have operations, but 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.
Dr. Sharp: I’m glad that you’re out there. It’s exciting to think about marketing and getting people in the door and that kind of thing, but back-end operation stuff is not sexy exactly, so it’s easy to overlook it.
Brie: So much. We think it’s sexy on our [00:12:00] end, but that’s because we’re operations people. You’re right, it’s not like the revenue income reports that you have on Instagram. People say, I’m completely booked out, I have X amount of clients or we’ve brought in this much, that’s great, but what does your bottom line look like? Because 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 been honing in on with our clients and constantly banging our heads against the wall shouting to people is that if you keep your expenses low and you keep that bottom line low, then if you lose clients, you’re not in an oh crap mode. You’re not like, oh my gosh, I have to get so many more clients So that just makes your profits even higher.
[00:13:00] I would say that the expenses side is more important. 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.
Dr. Sharp: Exactly. Just to zoom out a little bit more before we get into the details, what’s a good working definition of operations? We’ve used the back-end stuff, but how would you define operations for anybody who might be unclear?
Brie: The way that we define operations is the systems, processes, or strategies that keep your business running smoothly. So for practice owners, that could be your intake process, that could be how you onboard new clinicians, that could be a checklist of things that you have to look through every day to send to your biller.
[00:14:00] Essentially your operations and your processes are anything that is a repeatable task or that has more than one step, if you look at it that way. To go down to the nuts and bolts of it; it is repeatable tasks and anything that’s more than one step.
It can be anything in your practice that’s not somebody that I talked to two months ago. It’s like the front end, they are sales and the back end feels like operations. And so anything that’s not bringing in revenue necessarily, truly clients marketing things like that are operations.
Not to get too into it, but there’s also operations throughout those things as well but to make it as simplistic as possible, operations are part of the back-end, the expenses part of things, things that keep the cogwheels moving.
Dr. Sharp: Right. So there’s a lot of [00:15:00] overlap with SOPs, standard operating procedures.
Brie: We love an SOP.
Dr. Sharp: Okay. I do too. A good SOP.
Brie: It’s so good.
Dr. Sharp: We’re going to focus on client onboarding more than anything, which I love. This is a really important process. It’s also one that a lot of folks are winging. 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 talk about onboarding and measure onboarding, right?
Brie: Absolutely. That’s the biggest thing that, and honestly, we’ve worked with clients in other industries as well. I just had a conversation with someone yesterday that’s a lawyer and he was like, “I’m having an issue with following up on contracts.” It was literally his client onboarding process.
And [00:16:00] we talked about it, he’s like, “Okay, when we go to this meeting,” I was like, “Okay, backup, how do you get to the meeting?” “Oh, I sent them an email.” I’m like, “Okay, how did they find you?” And so we literally had to back up multiple times. It was like, where they find you, that’s where it starts.
So that’s another thing too, is the client onboarding process, a lot of people think it’s, oh, when you’re sending paperwork and then you schedule them for the first appointment. No, it starts when the marketing ends, that’s where it gets taken in.
Dr. Sharp: Let’s define that. What would you say is the first step in the onboarding process? And then where do we go from there? What are the major steps in the onboarding process?
Brie: Inquiry. And without going into itty-bitty details, but inquiry, consult, confirming that they are going to onboard, paperwork, scheduling for session, going [00:17:00] through first session. And then that goes into clinical, and then going through; making sure that they stay on boarded so that way they’re not churning out at, some people do it’s after 6 appointments, some do after 8. What is your churn rate usually?
Dr. Sharp: We’re lucky, just doing testing, there’s really no churn. Once people get in for the intake, they see the process through, which is great.
Brie: That’s true. You get that full completion process. So that’s really it; inquiry, consult, typically follow-ups, confirming onboarding paperwork, scheduling that first appointment. And then with testing and stuff, I know there’s multiple appointments and all of that, but that transitions into existing clients and clinical and all of that.
Dr. Sharp: Yes. I wonder if we maybe walk through each of [00:18:00] those steps in the process. I would love to hear things that you’re finding that work at each stage and things that are not working or pitfalls that people are running into at each stage. How about that?
Brie: Yeah, absolutely. 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.
I had a client several years ago that was nervous about turning online scheduling on in her EHR. I was like, I promise you it will make your life so much easier. And it did. She hasn’t looked back since.
I will say though that we find doing some sort of inquiry form before scheduling that consult is super beneficial for [00:19:00] screening those potential clients. 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.” You don’t have to waste that 15 minutes’ slot, especially when you’re crazy busy.
Also things, if somebody needs something that’s for, specifically, we work with a lot of social workers and so they get a lot of referrals for severe cases, and so a lot of those 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 doing right now.
So that’s another thing. For this one client that I work with, we get a lot of referrals [00:20:00] for teenagers. And so it’s their parents and they’re just getting out of an inpatient center and they’re having to do outpatient care. It’s stressful for the family.
And so the faster that we can get them through that process and saying, 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 still get referrals from people because you’re going above and beyond, even though you’re not doing that consult. So having that inquiry form is definitely a good way to screen people.
We had a client last year that was nervous about clients. 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.” [00:21:00] We, along with someone else on her team advised her, that’s probably not a good idea, but if you really want to do it, we’ll try it for 30 days.
It caused so many issues. She had way more no-shows for consults. There was a lot more work on the back end because there wasn’t a way for us, part of my team as the admin support, because 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.
It was creating more work for her. It was a cascade of things that just made everything worse. She’s like, “No, that was a bad idea. We’re going to bring the form on”
Dr. Sharp: Bring back the form.
Brie: Yes.
Dr. Sharp: Let me get super granular here. When you say an inquiry form, is this typically just a form that people fill out on [00:22:00] the website? Clients come to the website, they fill out the form, they submit it and it goes to either the psychologist or the admin person.
Brie: The process that we’ve created over 4.5 years, that works 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.
You click the link to schedule an appointment and it goes straight to this Google Form. Then from there, we’ll 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 consult. So that way it’s a smooth process.
And then 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 [00:23:00] see:
1. If they’re the right fit.
2. If they actually scheduled their consult in simple practice, because, let’s be honest, a lot of people will skip that step and close it out really fast, 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 consult. 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 typical contact information, first and last name, email address, phone number, age. So that way we know if they’re a minors 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.
Their session location preference; whether it’s in-person or virtual, which therapists they’re looking to have a consult with, any [00:24:00] details that might be helpful for the consult, and then payment preferences. If it’s out-of-pocket, out-of-network, some of the 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, hey, so and so with Aetna, and so that way they can see who has what.
Also ask their primary health insurance. These are questions that we’ve added throughout the years, because we’ve come into issues where people are like, oh, I have Aetna, but then don’t realize that it’s their secondary, and then it just causes a world of problems. I’m sure you’ve run into that.
Dr. Sharp: I’m sure. Yes.
Brie: And 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. Those 18, 19, 20-year-olds, 25-year-olds, 30 year [00:25:00] olds that their parents, grandparent or someone is paying for their care.
We’ve run into situations in the past with clients that a 20-year-old was utilizing her grandmother’s credit card. The grandmother 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 have an authorization so that way we can get release of information for HIPAA, and then we have that person sign all the forms as well so they know, hey, you’re on the hook for payment.
Dr. Sharp: Got you. Great.
Brie: So things like that, and of course, how did you find us? What’s your communication preference? Things like that. So it’s a lot of screener questions that we’ve just learned because from experience that, hey, we need to know this information upfront so that way we don’t get hit in the back end of like ooh, this is going to be an [00:26:00] issue. So all of that stuff can be done on the front end, which is great.
Dr. Sharp: That is great. I’m guessing there are probably some folks out there who are like, oh my gosh, what did she even just say? You submit a form, it goes to a spreadsheet, and then it notifies somebody, but just trust, it’s easy. This takes 5 minutes to set up.
Brie: Yes. Google Forms are super easy to set up. And then you literally just click a button that says export to spreadsheet and it automatically pulls it in for you. It’s a piece of cake.
Dr. Sharp: Yes. Great.
Brie: If you need help, just call us.
Dr. Sharp: Sure. People can help. There are people to help.
Brie: Asking for help is not a bad thing.
Dr. Sharp: Right. So that’s the inquiry phase. Where do we go next?
Brie: Obviously, if they didn’t schedule their consult. I will back up a little bit, if someone reaches out from like Psychology Today, My Well-being on Alma Headway, [00:27:00] all of the places or just emails directly on the website, I’m sending emails with the form.
We have email templates that we have saved in Google that you can literally click buttons and just pop it right in. It says, 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.
Our policy is to send, depending on what stage we’re in, three follow-up emails after that initial one because we do find that if someone is going to respond, they will typically respond by the third email.
Dr. Sharp: Okay, I just want to highlight that because this is a big question people ask us a lot in a lot of different circumstances; how many times do I reach out to someone before I let it go? You’re saying [00:28:00] three responses. Is this coming from some kind of data that you know people maybe don’t respond to the first one, but they will respond by the third one somehow?
Brie: It’s data that we have collected over the years. It’s not just therapy, it’s ad sales, it’s asking for sponsorships, it’s anytime that you’re trying to convince someone. The thing is, at the end of the day, therapy is a business.
That’s very black and white, but you are technically selling something. And so it’s really the same process whether you’re selling ads, selling therapy, selling services because a lot of people are like, oh, that looks interesting. I’m just going to leave it in my inbox for a while and I’ll get to it later.
Dr. Sharp: Yes.
Brie: And then the second email, oh right, I need to do that. And then the third email, oh, shoot, I actually [00:29:00] need to do that. They’re not going to leave me alone. They’re reminding me. A lot of times people are like, oh, thank you so much. I’m going to schedule the consult.
And then typically we send another one just in case that it goes into spam. 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 spam folder because that happens.
Dr. Sharp: It does happen. I want to highlight that. Just to say that again that a lot of us, or at least a lot of my consulting clients, there’s a fear of 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 get so many emails and I’m like, oh, that is interesting, [00:30:00] and then everything in my life happens and I forget about it. And then two more reminders, I’m like, okay. Good. Yes, I need to.
Brie: It finally bumps up to the top of the list once you get that third follow-up. Another thing too, is you’re not cold calling people. 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 supporting them.
Dr. Sharp: Exactly.
Brie: Especially with therapy, asking for help is hard and so people might not be ready the first time you send it. And then it’s just sitting in their inbox and like do I, don’t I? I don’t know. And that it shows that you care too. Honestly, it’s not a pester. It’s the fact that you really want to help them.
Dr. Sharp: Yes. Nice reframe.
Brie: Yes. I will tell you in my [00:31:00] personal therapy experience, the amount of therapists that I’ve reached out to that don’t even email me back is insane.
Dr. Sharp: I hear that so often. It’s crazy.
Brie: Do you not want clients? And if you don’t, great, then put that on your Psychology Today profile that you’re not accepting new clients or just email me back. So just being dedicated and treating people with a modicum of respect.
Dr. Sharp: Great.
Brie: After that, obviously we have the inquiry, once they get that email, they go through the inquiry process where they fill out the form, they schedule their consult. If they schedule a consult 3 weeks or more out, we reach out to them and say, hey, maybe the clinician’s on vacation or something, but they have spots open on [00:32:00] them, we could manually schedule. And so we always ask them, hey, do you want to get in earlier? 8 times out of 10, they say, yes.
It shows that you care. Throughout the whole process, you’ll 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 companywide. It can’t just be while they’re in session. So 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.
Dr. Sharp: I love that you mentioned that. Yes.
Brie: So consult happens. Typically, all our clients do 15-minute consults and then we have, I’m using roughly the same client just as a [00:33:00] 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 2020 and she came on in September 2020, and she’s still around.
She started her company in March 2020. So I’ve literally been there for pretty much the whole thing. She’s built a successful practice in New York City. She’s my Guinea pig. So anytime I want to test a new software, I’m like, “Hey, you up for it?” She’s like, “Yeah, absolutely.”
Dr. Sharp: Nice.
Brie: So she’s pioneering the operation stuff for us.
Dr. Sharp: I love that. Oh, that reminds me, when you mentioned software, up to this point, I’m curious if you’re using any software outside of Google Workspace. There’s a lot of chatter about CRMs and how do we keep track of this stuff, is it anything like that or are we just keeping it simple?
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Let’s get back to the podcast.
Brie: Up to this point, I’m just using Google. If you’re using Microsoft, run away really fast and get on Google please; Gmail, Google Sheets, and Google Forms so far, and then [00:36:00] whatever your website platform is.
Dr. Sharp: Fantastic.
Brie: Which could be like Weebly. It doesn’t have to be perfect. You can even create a Google Site if you really wanted to. So consult happens and then with our star client, what we do is the clinician has an email template that they send. It’s a follow-up email.
Obviously, if the client says, hard, no, can’t do it. They’ll still send a follow-up email, thank you so much for your time. They CC the admin team, so the admin team knows what to do next. And so they’ll off board them from the EHR.
We always put a little note. We use SimplePractice for most of our clients. We’ll put an admin note on there saying we’ll not onboard after consult. So that way when we go back through inactive clients, we can see who is this person? Why didn’t they not onboard? And then we know.
[00:37:00] But the people that are thinking about it or are gung-ho about moving forward, they’ll be warm and say, 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 3.00 PM biweekly. My rate is XYZ, or you are looking to use your in-network benefits with Aetna.
And so it has, especially 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 confirm everything in writing from the consult, which is really important. And then also just notifies the admin team so that the clinician doesn’t have [00:38:00] 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 the admin team takes it from there. We’ll respond within, usually, we give them a day or two and if they haven’t responded yet, we’ll follow up and say, “Hey, I’m so glad that you and so connected, please let us know how we can support you on 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 schedule an appointment, and then that’s more work for you.
So we found, to get them on the schedule for that first appointment and then send all the paperwork and we have an onboarding email template that says, you’ll be getting an email from SimplePractice. This is your client portal, yada, yada. You have a bunch of paperwork, fill it out 24 hours before.
For this practice specifically, as my [00:39:00] example, they use Alma for their in-network. So you’ll also be getting an email from Alma. This is where we submit claims and you’ll get all the information from that. So that way they know what to expect because if you’re just getting random emails with a bunch of paperwork, you’re like what is this? This is so overwhelming. And so letting the client know what to expect is so important too. And then making sure that you’re open for questions and everything like that.
If they don’t respond right away, we send four follow-ups for that, because they’re already are more than a warm lead, they’ve gone through all this whole process, they’ve had the consult. A lot of times the clinician will be like, I don’t know why they didn’t respond because they were like, yes, let’s do it in the call, and then they just ghost, it happens.
Dr. Sharp: I’m [00:40:00] curious why the clinician wouldn’t go ahead and book the appointment from the consult, why that extra friction to CC the admin team and then have them follow up?
Brie: 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 is that the clinicians solely can focus on clinical. She set it up as a boutique practice and it’s to focus on the therapy. And so the admin support team takes care of everything else. They take care of scheduling, rescheduling, canceled as needed. We make sure there’s a boundary between anything clinical and anything admin. That’s why.
Dr. Sharp: Got you. [00:41:00] Maybe asking for those solo practitioners out there or others who might want to do it different, do you see any downside to just booking straight into the appointment in the consult?
Brie: 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 consult call with them, book it, send the paperwork, just do it right on the call. It’ll take you 2 minutes. I’m sending it to you right now. You should expect it in your inbox. Make sure you give a timeline of, please fill it out 24 hours prior or 12 hours prior, whatever, just so you can look it over, and make sure there’s no outstanding weird things going on.
If you have an admin support person of any kind, whether it’s a VA, a whole scheduling team, whatever, if you want them to send the paperwork, you just had to make sure you have clear, open lines of communication. So if you are booking the appointment or booking [00:42:00] the recurring appointment series, letting them know, hey, this person’s a go. I booked them for the first appointment. Can you do the rest?
And so that way, you just communicate because that’s where we find where you have the consult 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 the next day and it’s like, why didn’t you send the paperwork? Because you didn’t tell me to. So it’s about that open, transparent communication too.
Dr. Sharp: Got you. Great.
Brie: From there we keep a close eye on paperwork, make sure we’re following up. Typically, about three or four days prior to 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 [00:43:00] not, “Hey, you haven’t done your paperwork yet. You have to get it done.” It’s like, “Hey, do you have any questions? We noticed that you haven’t finished it. Anything we can support you on.” Reframing it in a way that is supportive to them, but also like, hey, get your stuff done.
Dr. Sharp: Right.
Brie: And then they have their onboarding. And then from there, the clinician completely takes over. And then if they need anything with billing or scheduling, we have great communication.
Dr. Sharp: Great. Let me ask you a question about the paperwork.
Brie: Yes.
Dr. Sharp: Have you found anything, because there’s a lot of debate about this and people ask this question a lot, basically, how much paperwork is too much? I feel like we have a million forms. We tried to simplify them, but it’s a lot. Our demographic form is pretty [00:44:00] long. So there’s a question of, do you do a longer demographic form or do a shorter and then do more of the intake? What have you found just in working with a bunch of practices in terms of people filling out paperwork?
Brie: 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 1.5 million forms for my child who is also in play therapy, OT, speech, physical therapy. I’ve done all of the intake processes. I’ve seen them all.
I will say that when you’re talking about demographics or intake questionnaires, the quality of your paperwork is also important. [00:45:00] So from that point of looking at if you have a lot of open-ended questions, that can seem super overwhelming versus if there’s a way, instead of like, do you smoke? Instead of having an open-ended question, you could just have a drop-down or a multiple-choice question. That makes it feel less overwhelming. Something like that makes it feel a lot quicker too, and a lot more manageable.
My son tried ABA therapy earlier in 2024. With ABA, you have to fill out all the forms ahead of time before you’re onboarded 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. It would take me 15 [00:46:00] minutes to fill out these intake forms. Of course, they’re all super negative because you have to be like what’s wrong with your child?
Dr. Sharp: Oh gosh.
Brie: I applied to 20 different waitlists 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 those multiple-choice questions and things like that.
I will say from a business owner’s standpoint, whatever amount of paperwork gets you the information you need and covers you legally is the number of documents that you need. I have a client, her husband’s a lawyer, and [00:47:00] she’s paranoid about being ever audited or anything. She’s like, “I don’t want to be that person on the news that has the horrible malpractice” She’s like, “I’m not going to be the person on the news. I’m going to be locked so tight on legal. We have all of our policies in place. No one is going to be able to dispute charges, we are locked in.”
And also a lot of information for clinicians. It’s 17 forms that go out for onboarding. There’s the DOS screener, the GAD-7, the PHQ, those are three of them but there’s a therapeutic process understanding, confidentiality, the HIPAA policy, things like that. There’s a COVID waiver because that’s required in New York. That’s a bunch right there that take you 5 minutes to sign. So it seems like a lot, but it’s oh, it’s a paragraph I have to read and sign. Okay, great.
A lot of people [00:48:00] put all of that on 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 4.5 years, we’ve had three people ever that said I cannot do these documents. It’s too much. That’s it, three people for four years. They average between 150 and 200 clients on their roster at a time.
Dr. Sharp: Got you.
Brie: We’re consistently onboarding 10 people per month. It’s a very small number. You have to remember that you’re a therapist, but also a business owner. So the last thing you want is having someone come after you for some reason [00:49:00] of probably no fault of your own, of someone, even an ex of a client that is abusive, or 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.
I think the right answer is 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 a very diplomatic answer.
Dr. Sharp: Yeah, super diplomatic. It’s okay. There’s some of… it just depends as well.
Brie: Yeah, it depends. There’s one therapist that I went to that didn’t have any, I didn’t even sign a HIPAA form. She’s like, let’s do therapy.
Dr. Sharp: Here we go.
Brie: Here we [00:50:00] go.
Dr. Sharp: Are you cool? I’m cool. Let’s do it.
Brie: If you want to burn down your company and just do paper calendar and stuff, do what you want to do.
Dr. Sharp: That’s a good plan. Even this component of trying to eliminate open-ended questions from our forms, I get it. From a clinical standpoint, they’re helpful, but from a consumer standpoint …
Brie: There’s definitely some that you need, but there are some that can be multiple choice or a multiple choice with a short answer depending on what. We 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 the new year paperwork.
The intake forms, a lot of them were where I would be able to combine three questions into one where I could do one question and then for each answer, it could be like, you click yes [00:51:00] and then it pulls up another little box. It’s like, okay, tell me more information here.
Dr. Sharp: Yeah, even having an eye toward simplicity, I think you’re right. There’s a lot that we could combine. There’s some fluff in there. We’re always trying to revise.
Brie: Honestly, it even comes down to formatting.
Dr. Sharp: Yes.
Brie: Putting those little line spacers, headers, sections and bolding, italicizing, all of that, it just breaks it up so it doesn’t seem as overwhelming too.
Dr. Sharp: Yes. It goes a long way.
Brie: The psychology of paperwork too, if you want to get into it.
Dr. Sharp: That would be a great podcast, the psychology of paperwork.
Brie: I don’t think I’m qualified for that one.
Dr. Sharp: If you find me someone, send them my direction.
Brie: I will.
Dr. Sharp: So big question, a lot of practices are collecting credit cards upfront upon booking, but then there are many, they’re saying, we don’t do that. We’re not going to do that. Any best practices [00:52:00] around that or ways you found to ease that process?
Brie: I have a very polar answer to this. This might be an unpopular opinion, I don’t know. I do not like when someone asks for a credit card before a free consult. I feel like it feels overwhelming. It feels like, oh my gosh, why do they need my credit card? I haven’t even decided if I’m going to go with this person. I’m doing consults with two different people and then they’re going to have my credit card information, which I’m not 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 from a personal standpoint but also from a business standpoint, I have seen where people don’t go through with the paperwork for the consult. It’s hard to get people to fill out paperwork for a consult, to be frank. And also I [00:53:00] have seen where people no show on consults because they don’t want to submit that information.
When it comes to onboarding and scheduling that first appointment, heck yeah, make sure you have that credit card before. If they don’t have it before, we typically tell them, we have to reschedule your first appointment because we need all of your paperwork done.
Dr. Sharp: That makes sense. Great.
Brie: And feel free to disagree with me, getting people in for a consult for therapy is already tough. people have to be ready to go to therapy. and so then I feel like asking them to fill out a demographic form is one thing, but asking them to put their money where their mouth is and put the credit card on file for a free consult just seems [00:54:00] like it’s too much of a barrier to entry.
Dr. Sharp: That’s fair. I’m totally with you. I should have clarified, I don’t know that we’re trying to do a credit card before the consult, but before booking an actual appointment.
Brie: 100%. Oh, yeah. Because we book the first appointment before we send paperwork a lot of the time, we will say you have to have your everything done 24 hours prior to the first appointment. And then if it’s not, we reschedule that appointment out.
I think we’ve gone to the policy where once you fill out your paperwork, we will schedule that first appointment. And so that way, they get one buffer where they’re like ah, 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.
Dr. Sharp: Totally.
Brie: Boundaries.
Dr. Sharp: There you go. Trust but verify.
Brie: Yes. Exactly.
Dr. Sharp: Maybe [00:55:00] we start to wrap up with a question that is almost, I almost said on the flip side or an opposite problem, but it’s all part of the deal. And that question is, how do we work with a high volume of inquiries? I’m guessing you work with some practices and this, full transparency, this is very selfish question, because this is our main problem. That’s why I do these podcasts is just to answer my own questions.
Brie: Why not?
Brie: The question is; how do you deal with a really high volume of inquiries? I cannot just keep hiring admin staff to create more and more consult appointments or answer more phone calls. So I’m curious how you think about a problem like that where you’re getting way more inquiries than you have the time in a week to deal with.
Brie: That is where I would bring a CRM in, so customer relationship [00:56:00] management. I will say I have used a lot of CRMs in my day. 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 WisePractice. They soft-launched in April and then they fully launched in July, and they’ve done 20 iterations since then. It’s fantastic. And that’s coming from an operations person. If you need it, I’ll send you my affiliate link.
Dr. Sharp: Hey, I would love to check it out.
Brie: The thing that I love about a CRM like WisePractice is that it has workflows. Workflow, for anybody that doesn’t know what that is an automated process that can do the [00:57:00] 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 support tickets and things like that, where we can automate our follow-ups, which was really great.
But Zendesk, their business model is terrible and their customer service is terrible and they’re super expensive, so I highly do not recommend them. However, something like WisePractice, you can have that communication where you connect your, it’s a two-way sync with your Gmail. It’s fully HIPAA compliant.
You can do your workflows. You can do even documents through there. There’s other opportunities where if you do webinars and courses for other therapists using Kajabi or something like that, you can pull all of that in there. Jeremy’s oh my gosh, what is this?
Dr. Sharp: Yeah. Seriously. I’m going to have to end our podcast now and go check out WisePractice. Sorry, Brie, sorry.
Brie: No, that’s okay. As long as you use my affiliate code. I’m just [00:58:00] kidding. The cool thing and I’m excited to try it out in typical business owner fashion, I really want to bill 1 hour to test it out and I don’t have time. That’s my goal for Q1 of 2025 is to test it out.
What we can do with it is have the inquiry form in WisePractice and once somebody submits it, we can send them a thank you email and send a reminder to schedule the consult automatically. And then we can send reminder emails automatically. It’s an if then; if they haven’t responded by this day, then send out this follow up and things like that.
Also the cool thing about this is that, I’m sure you’re aware of this, some people email, some people text, some people call and you have to search, oh, did this person send me anything and you have to search in 10 different places in secure [00:59:00] messaging.
In WisePractice, you can take all of the texting, the calling and the emailing and it’s all together in the client’s contact information. So you can see when they texted, when they emailed all in one spot, which is very cool. Even that extra 2 minutes or 5 minutes that it takes you to go on the three different platforms you need to check, it’s all right there.
Dr. Sharp: It adds on. Fantastic. I am going to do some homework on WisePractice.
Brie: Yes, definitely do. If you have any questions, let me know.
Dr. Sharp: Great. This has been awesome. I love doing a deep dive into this one aspect of practice management.
Brie: It’s an important one.
Dr. Sharp: It is. Maybe the most important.
Brie: One thing we didn’t talk about too, is the reason why you want to streamline your process [01:00:00] is that each person, because I feel like somebody listening to this episode will be like, okay, that’s great, but why am I doing all of this? That seems like way too much work.
And so the reason you want to do this is:
1. Making sure that every client has the same experience.
2. 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? Are you sending follow-ups? Are they falling off after the consult? What does your consultation look like? Maybe do a role-play and see 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, [01:01:00] because it’s both ways. It’s an interview both ways.
And then looking at, okay, 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? Why did they not show up for their first appointment? Things like that.
And so you can really see where your issues lie and be able to fix those. You’re caring for your client all the way through the process, regardless of it’s in session or out of session.
Dr. Sharp: 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. If you have data …
Brie: Math and communication.
Dr. Sharp: Math and communication, there we go. That’s so true though, tracking all these things gives you a lot of insight into what’s not working.
Brie: Yeah, absolutely.
Dr. Sharp: Or what is working?
Brie: Yes. Exactly. Because that’s important too.
Dr. Sharp: Sure.
Brie: You got to celebrate those [01:02:00] wins.
Dr. Sharp: Absolutely. Yes. 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?
Brie: If you want to learn more about us, our website is chock full of information. It’s heybossco.com. You can email us at heybossco.com. We’re on Instagram dropping knowledge. We send out two newsletters a month with tips, tricks and knowledge of how you can support yourself and how to create efficiencies and just make your life a little easier. I’m excited for that too.
Dr. Sharp: Sweet. All that will be in the show notes, go check it out.
Brie: Oh, we also have in the show notes will be a freebie for anybody listening. It is a quick PDF of the client onboarding paperwork checklist so you can look at what you need for demographics, for therapeutic [01:02:00] processes, for billing, and all of that. So that way you can audit what you have and then see if you need anything else.
Dr. Sharp: 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, are you a Clemson or South Carolina fan?
Brie: Neither, I am a Hokies fan.
Dr. Sharp: Fine. We’re done.
Brie: Delete the whole episode.
Dr. Sharp: All right. Fine.
Brie: Go Hokies all the way.
Dr. Sharp: Okay. Seriously, I appreciate your time. This was fun. Thanks for being here.
Brie: Thank you. It was a great conversation. I appreciate it, Jeremy.
Dr. Sharp: All right, 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 [01:04:00] 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, we 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, you can check out the details at thetestingpsychologist.com/consulting. 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.
[01:05:00] 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 the host or guests of this podcast and listeners of this podcast.
If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.
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