My thoughts on alma and taking insurance
Why I wanted to Take Insurance
Starting out as a private practice therapist I knew I wanted to take insurance. There were two reasons for this:
I wanted to be accessible for people. If you don’t take insurance you are out of reach for a lot of people who need help.
It helps to build the practice. If you take insurance you are able to grow your caseload faster.
But, working with insurance companies is complicated. You have to reach out and get “paneled,” it can take months or maybe even a year to get a response AND they can turn you down!
They may say things like “Your area is oversaturated and we don’t need more providers for your specialty.”
Once you are approved by insurance companies they tell you the rate they pay for sessions. This varies based on the insurance company.
Each company might use a different platform for claim submission and there are a lot of rules.
Some insurance companies are easy to work with, others it feels like banging your head against a wall. There is one company in particular that is big and complicated and makes it tough to get answers. Even my Mom (who is not a provider but worked in medical billing for different MDs for many years) said that this unnamed company was “a nightmare to work with”.
When I was starting my private practice I got paneled with two insurance companies on my own. I was excited, but eventually, I grew tired of being reimbursed $60-70 per session by one of them and removed myself. I lost a couple of clients but I felt like I wasn’t being paid fairly. Then Alma reached out to me. Alma was new. It was COVID and I had built an entirely online/virtual practice. But I wanted to grow and I was SICK of spending hours on the phone figuring out why I wasn’t getting paid by insurance companies or why after telling me that I was in-network for someone the claim got rejected because I was in fact NOT in-network for them (this happened - I called, was told the client would just have a copay and after the first session - where she shared her experience of being sexually assaulted - I received a rejection and had to ask the client to pay out of pocket).
Why I Went with Alma
Alma gave a great presentation about how they would simplify my life as a clinician running a business. Here are the reasons I bought in:
They were going to help me get credentialed with insurance companies more quickly than if I had done it on my own.
I would always get reimbursed for virtual sessions. During COVID clinicians were being reimbursed for virtual sessions but we were always told that at any time this option could be taken away. Which is a problem if you run a fully online practice.
Rates were higher if I was credentialed through them.
Payout was consistent. Alma pays weekly. There were some insurance companies still sending me checks in the mail or taking weeks to process and payout a claim. I couldn’t budget or plan that way. With Alma my income would be way more predictable.
So I signed on. The monthly cost of Alma was roughly the equivalent of one 60 minute session. For all that they offered, while also allowing me to maintain full control of my business, it seemed totally worth it. And it was, until the recent news about Aetna changing reimbursement rates for clinicians credentialed through Alma was released.
My Final Thoughts
Do I think this was the plan all along? I have no idea.
Do I think it is OK? Absolutely, not.
Am I angry? Yes.
Am I considering removing myself from Alma and going private pay only? Also, yes.
Am I scared? Yup.
I truly believe that using Alma helped me build and maintain my practice. Being listed on their site has brought in a lot of clients over the years. But it may be time to move on.