Are You Actually Ready to Depanel from Insurance? [4 Things to Check First] (Episode 92)
De-paneling from insurance can feel like pulling out the safety net. You may know exactly why you want to make the transition—higher fees, more control over your caseload, fewer insurance headaches—but knowing why you're leaving insurance isn't the same as knowing what needs to be in place to make the transition successfully.
In this episode, Anna breaks down the four things she sees in clinicians who make the move to a full-fee private practice with confidence. From getting specific about who you're serving to becoming grounded in your fee, making sure your website matches the experience you're asking clients to pay for, and developing the mindset to stay steady when your caseload dips, Anna walks through the foundation you need before making this leap.
Here’s what you’ll learn in this episode:
1️⃣ Why knowing why you want to de-panel isn't enough—you also need to know who you're de-paneling in service of.
2️⃣ How getting grounded in your fee means more than choosing a number, and why you need to be able to state it without immediately reaching for a discount.
3️⃣ Why your website needs to match the experience you're asking someone to pay out of pocket for, especially when you don't yet have years of reputation and referrals behind you.
4️⃣ Why holding steady through an empty or dipping caseload is part of the job—and why moving to private pay means becoming an active CEO and marketer of your practice.
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Hey, hey, happy Tuesday to you. I hope it's feeling like fall wherever you are, 'cause it sure as heck is not in Nashville. We actually broke a record last week. We hit 100 degrees for the first time in, like, 100 years. It has not felt even a little bit like fall here. So hopefully you're getting more of that.
Hopefully we're all headed in that direction. September is nearing its end, which is wild. We're gonna be getting into Q4, and I have been talking to a number of you who are planning to de-panel from insurance. We've had a handful of our Confident Copy Live students preparing to fully de-panel in the next month or so, and I've talked to a couple of others
who are planning to do so right around the new year transition. And this is a really, really important marketing juncture in your practice, right? I love seeing clinicians decide to make this leap if it's the right one for them. Obviously, some clinicians choose to take insurance, and I think that's fantastic.
If you're someone who is deciding to de-panel and to go to a completely private pay model, you're likely thinking about what that is going to mean about your marketing.
If you have decided to de-panel, you're probably pretty comfortable with why, right? You know that you maybe want to have a higher fee. You want to have more take-home revenue, right? You want more say over your caseload. You wanna stop worrying about clawbacks, whatever that is. You know why you want to do this.
What I see a lot of clinicians stumble around is what they need to have in place in order to make that leap. De-paneling is a leap of faith. That's how I've heard many of you describe it, and I've heard others say it felt like they're pulling out the safety net. That's not to say that you can just simply open up an insurance practice and get full, but what is asked of you as a full-fee, premium-fee practice from a marketing perspective is gonna be different than from an insurance perspective.
And this is a juncture at which we support a lot of our done-for-you clients. Many times folks will come to us saying, "I've had an insurance-based practice, but I'm preparing to de-panel, and I know my website needs to up-level with me." And so I often get to sit with a lot of clinicians really at this point in their practice, and it's an important one.
Now, what I want to talk about today is the foundation that needs to be in place for you to make this leap confidently or at least as confidently as you can make a leap of faith, right? Because there is gonna be a little bit of faith always involved. Now, like I said, you probably know you're ready. You probably feel fed up with the insurance thing.
Whatever it is, you know that you're going to do this, but you maybe don't know what needs to be in place to actually make it happen. Now, there are some logistical things you're gonna wanna do. That's not what this is about. This is more on the marketing and the mindset side. What boxes do you need to check in order to know with confidence that you're making the right move, right? So this conversation was, as I mentioned, inspired by a lot of the conversations I've had with those of you who are making this transition and realizing that your website needs to be up-leveled along with it, right?
We know that when your website is set up to establish you as the go-to expert in your niche and your area, that you can command higher fees, that you can make that yes easier, that the standards that someone who is going to hand over $250 a session has for marketing are pretty dang high, and that your website's job is to meet those standards, is to provide a taste of the experience they can expect to have with you in the therapy room.
These are all the things that we know. The other thing that inspired this episode was a really cool conversation I saw in Audrey Shane's Balanced Private Practice Facebook group, and I will link it here in the show notes. But Audrey asked a really fantastic question, essentially, "Of those therapists in this group who are doing really well and are successful, what do you attribute that success to?"
And last I checked, I think there were 60 or 70 comments, and holy cow, were they insightful. To hear from people who are charging premium fees, who do have full caseloads and wait lists, what do they think played into it, right? And so looking at that and that kind of sparking some thoughts for me, and then also reflecting on the conversations I've had with so many of you as you make this shift, has led me to really boil down the foundation, kind of that de-paneling foundation that I see into four things.
And we're gonna talk about what those are today, okay? Now, I wanna be clear that this is not like do not de-panel unless kind of like scary things. It's kind of more like, "Hey, what's the common denominator for the people that are achieving success? What is in place? What is actually pulling weight?
And what do you maybe not have to worry about as much if you're gonna decide to move away from insurance?" When people have a hard time de-paneling, most of that hard time, most of that pain or that struggle isn't necessarily about the actual de-paneling, but it's that they de-paneled without a plan, essentially.
So from my perspective, in the conversations that I had, in the practices I have witnessed make this transition and do so successfully, you should definitely check out episode 67 where I interviewed Monica Kelly, she's a fantastic example of this, and to see what all of these incredibly talented clinicians had to say in that Facebook group, here's what has to be true.
One, you need to know who you're serving specifically with this new private pay model. Two, you gotta be grounded in your fee. You need to know it and feel confident in it. Three, your website needs to match the experience you are now asking someone to pay out of pocket for. And four, you need to be able to hold steady when your caseload isn't full yet or when it dips.
Those are the four things. Let's get into them. One, you need to know who you're serving specifically. Now, wanting more full-fee clients, making this decision to de-panel is allowed to be a decision for yourself. You're allowed to make that decision for your family. You're allowed to make that decision for your financial goals, for your wellbeing to avoid burnout, whatever.
You're allowed to make that decision because of you. However, marketing is not going to ultimately run on your motivation. It's going to run on your client's motivation to book with you. Okay? So you can de-panel for your own reasons. You can't market for your own reasons. What do I mean by that? I mean that the people who are paying $175, $200, $250 out of pocket aren't choosing you because you've been doing this for 30 years or because you're five minutes from their house.
They're choosing you for a reason, and your niche is that reason. Your niche is the reason people decide to work with you. So if you don't name it, if you don't know it clearly, then you are not giving them a reason to choose you over anyone else who's charging the same fee or less.
Okay? So when you think about de-paneling, you need to know who you're de-paneling in service of. Who is this newly private pay practice meant for, and how do we show them that this is the place for them? Can you say who you're for? Can you talk about your niche without fumbling over it? Could your ideal client read your niche, experience your website, and see themselves in it?
And if you've been listening to our recent episodes around being magnetic, is your marketing, your niche magnetic enough that the wrong fit is going to not recognize themselves and opt out? All of these things need to be clear. If you are attempting to market yourself as a full-fee provider and wanting to be all things to all people or not wanting to repel anyone, you're gonna have a really hard time, especially in this market where specificity is truly the name of the game.
So you can de-panel because that's what the right thing is for you. You cannot market that way. You need to be marketing to a specific person and with a specific person in mind. Okay? So making sure you have that in place. Next up, you need to be grounded in your fee. I was searching for a new therapist for myself ...
I'm trying to think. I guess it would've been about four years ago, and had a handful of consults with some clinicians here in Nashville, and I will never forget on one of them, I asked her what her fee is. She didn't offer it up, which is fine. But I asked her what her fee is. She stated it, and then she immediately followed up with the fact that she offered sliding scale.
Now, I didn't need a sliding scale spot, and I was planning to pay out of pocket, but it was really interesting to me that she just immediately rushed to fill that space. Can you state your fee and then shut up? That's the best guidance I've seen out there when it comes to stating your fee and, and working through it on a consult call, is saying it and then being quiet.
Can you do that?
Feeling good about your fee sounds like the ability to be quiet.
If someone says, "That's not gonna work for me," then your instinct might be to reach for that sliding scale, and maybe you do have room for it. But only be able to offer it if it's a real and intentional option you have. You've run the numbers, you're firm in them, you know what is available to you as far as sliding scale spots goes, and if the answer is, "Okay, then I would be happy to refer you to another clinician," are you comfortable doing that?
Have you run the math? Are you confident in the math? And are you willing to state it and stand by it? Can you hold that number and let some people say no? This is something that's gonna come with practice, no doubt about it. Your first consult as a full-fee clinician might not be as smooth as the one you do three years from now, but that is something that you need to be moving in the direction of.
And I only say that because I've seen the clinicians who have gone ahead and stepped into this role either struggle because they really aren't grounded in why their fee is what it is or are really, really solid in it. They've done the numbers. They know what they're worth. They're willing to say it.
Which one are you? I want you to be that latter one in order to, to make this transition. Okay, next up, your website needs to match the experience that you are now asking someone to pay out of pocket for. Does your website right now match the experience that you're asking someone to pay out of pocket for?
Let me be clear. This has nothing to do with how good you are clinically. 'Cause you're not really changing, right, when you go from insurance to private pay. You're the same clinician. You're gonna keep growing, but as of right now, nothing changed clinically. But when you move from insurance to full fee, something has to up-level in how people experience you before they pay.
Not because your work got better, but because we know that money decisions are emotional decisions. Across the board, even when there are C-level executives purchasing software for their Fortune five hundred companies, guess what? Those decisions are still driven by emotion. So a two hundred and fifty dollar decision requires a different emotional experience than a thirty dollar copay decision.
Again, this says nothing about you as a clinician, but what does it say about the experience that you are offering people? That's what your website has to do at this stage. Now, safe to say, plenty of full and thriving practices run on subpar websites. Absolutely. So if you have the years and the referral network and the reputation already built, maybe you don't need a complete overhaul of your website.
I absolutely know people who have incredibly successful practices. I'd land on their website, and I wouldn't necessarily guess that. I'm willing to be wrong here, certainly. But what I have seen is that the clinicians that this hits hardest are the ones who are entering full fee for the first time, right?
They don't have that runway of reputation behind them yet. They don't necessarily have all of those years of networking. They don't necessarily have that referral base. And so for them, the website needs to do the work that that reputation maybe would have helped them do if they'd been in the game a little bit longer.
That's why at this point in this market, I think that we need to make sure that your website is not running the risk of being a liability to your practice. If you can afford to do that, then why fix what ain't broken, right? You're always gonna hear me say that. An ugly website, ugly is extreme, but an ugly website is not a problem by itself. But it can be a problem when it is asked to do a job that it wasn't really built for, right? And that's where it can turn from a non-issue into an active liability in the event that you can't rely on your reputation or your referral base the same way.
So again, does your website match the experience you're now asking someone to pay for? If not, we need to do that so that it can be an asset to you and not run the risk of being a liability. All right, last but not least, as you prepare to make this shift, and this is gonna be something that you live and grow into, but holy cow, does this matter, you need to be able to hold steady when your caseload isn't full yet or when it dips, because it will.
This is not an if situation, this is a when. I don't know a single fully booked clinician who has stayed steady, steadily booked month in and month out, year over year. I've talked to a lot of you who have experienced a dip this year . Maybe it's rebounded yet, maybe it hasn't. But being a private pay clinician in this market means having a level of tenacity and a level of groundedness that you didn't used to, to need. You can have the tactical pieces in place here.
You can have a solid fee. You can have a website that matches it, but what about your nervous system, right? Can you stay grounded when your caseload dips, when inquiries slow, when it feels quiet, when you haven't gotten a consult in a couple of weeks? When you choose to de-panel, you're not just a therapist anymore.
You've become a new kind of CEO. You've also become the CMO, the chief marketing officer, and it's a job most clinicians never sign up for, or at least didn't intend to. But it is an active process. So deciding to de-panel, doing so successfully means realizing that you are signing up to engage in a new active process of relating to your business, marketing it, staying open to optimizing it, and pivoting for as long as that practice remains open.
This is not a build it and they will come Field of Dream situation. It's out there marketing yourself, trying things, staying open to changing what isn't working
Now at some point or another, you're probably gonna have that moment of panic, right? You're gonna have that spiral on the couch with your partner. You're gonna wanna burn it all down and work at Costco, as I say. Ask me how I know. Those things are gonna happen, but are you entering into this with your eyes wide open?
With an understanding of what may be required of you now, and deciding ahead of time that you have the tenacity and the self-trust and the confidence in your decision to stay steady?
So again, those four things that need to be true, you know who you're serving specifically, you're grounded in your fee, your website matches the experience you're now asking someone to pay out of pocket for, and you can hold steady when the caseload isn't full yet or when it dips. Are all four of those things true?
Now, as I mentioned, this is often a juncture at which we support a lot of clinicians with our done-for-you website services because they recognize their website needs to do some more heavy lifting than it used to, right? They know that their website has to match the fee and the caliber of clinician they've become and are becoming.
They know it has to say, "What you see here is what you're gonna experience with me." They know that it has to give someone an actual reason to choose them and then prime them for the fee before the consult call. They know these things about their website, and it's our absolute and utter joy to get to support them in that.
Now, we offer done-for-you copywriting if you're finding that the copy is your sticking point. We offer done-for-you branding to create a visual experience that you can bring, not just into your website, but into all of your marketing. And then we offer website design, where we build and design and launch the thing for you.
Now, you can choose from one of those if all you need is copywriting. Pair it with one of our templates that's included in the service. We can do all three. It's up to you. But what I see happen is that clinicians will often make this decision to de-panel. They're ready. They're, they're burned out on insurance work, whatever that is.
They know they need to do it, and then their marketing doesn't catch up, and so they experience this lag. Maybe eventually it'll catch up, but they aren't entering into that transition as well-equipped as they could. And when you invest in your website doing its job, you get not just a website, but you get the confidence that comes with it.
You get the self-assuredness of sending that website to a referral contact, to a potential client, knowing it's gonna do its job, right? And you start to establish yourself and, and stand apart from the tens, hundreds of other clinicians around you.
Your website is going before you. Your website, when set up right, can prime your clients for your higher fees. That's what happens when this is built right, right? It lets your fee make sense before they even talk to you. Is that gonna be right for everyone? Of course not. But if your aim is to make this transition and make it well, then these four things need to be in place, and your website needs to do some heavy hitting it didn't used to have to.
If you're sitting here and thinking about, "Oh my gosh, the idea of writing this new niche is completely overwhelming," or, "I have no idea how to create a premium-feeling website that matches the experience I'm gonna offer," let us help. Like I said, it may be it's one service, maybe it's two, maybe it's all three, but whatever is keeping you stuck, let's get you unstuck and get you moving forward toward this goal.
Depaneling is a bit of a leap of faith.
There's absolutely no doubt about it, and it requires a healthy mindset and a tenacity and a willingness to do hard things paired with a couple of really solid tactical things, a good fee, confidence in your fee, and a website that backs it up.
Build these things on purpose. None of these things are going to happen by accident. You're not gonna accidentally be confident in your niche. You're not gonna accidentally have a premium feeling website. You're not gonna accidentally have the type of mindset that is going to weather the ups and downs of full fee practice ownership.
Be intentional about these things. Do these things on purpose, and in the areas where you're stuck, ask for help. Don't stay stuck there. The rut will only get deeper. I've seen it happen. If one of our services could be helpful for you, jump over to walkerstrategyco.com/services. Book a free call with me. We can talk about whether one, two, or three of these services is a good fit for you.
If it's not, I'll always point you in the direction of what I think might serve you best. If you're deciding to make this transition and you needed just a little bit of guidance on where to be thinking, I hope that this episode was useful for you. I'm cheering you on. You've always got me in your corner. I'll see you in our next episode.
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About Marketing Therapy
Marketing Therapy is the podcast where therapists learn how to market their private practices without burnout, self-doubt, or sleazy tactics. Hosted by Anna Walker—marketing coach, strategist, and founder of Walker Strategy Co—each episode brings you clear, grounded advice to help you attract the right-fit, full-fee clients and grow a practice you feel proud of.
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