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Just curious.
Not there yet, but what's the upside for doing pro bono in private practice exactly? I could see using it as a marketing tool.
You REALLY don't want to advertise that you do pro bono work. If you do, people will categorize you as the "free care" option. Then they send you all the BS stuff, and send the paying work to someone else.Not there yet, but what's the upside for doing pro bono in private practice exactly? I could see using it as a marketing tool.
You REALLY don't want to advertise that you do pro bono work. If you do, people will categorize you as the "free care" option. Then they send you all the BS stuff, and send the paying work to someone else.
Remember that the last sentence there includes things like volunteering (including board membership) for local, regional, national professional organizations, local agency professional advisory boards, community events (e.g. autism walks), giving a free talk a senior or other community center, etc.Principle B: Fidelity and Responsibility
Psychologists establish relationships of trust with those with whom they work. They are aware of their professional and scientific responsibilities to society and to the specific communities in which they work. Psychologists uphold professional standards of conduct, clarify their professional roles and obligations, accept appropriate responsibility for their behavior, and seek to manage conflicts of interest that could lead to exploitation or harm. Psychologists consult with, refer to, or cooperate with other professionals and institutions to the extent needed to serve the best interests of those with whom they work. They are concerned about the ethical compliance of their colleagues' scientific and professional conduct. Psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.
No therapy or assessment pro bono work, but I'm part of a 3-person grant writing team for my kids' PTA. We've submitted three grants this academic year, each taking the lead once. I think that counts.
Principle B: Fidelity and Responsibility
Psychologists establish relationships of trust with those with whom they work. They are aware of their professional and scientific responsibilities to society and to the specific communities in which they work. Psychologists uphold professional standards of conduct, clarify their professional roles and obligations, accept appropriate responsibility for their behavior, and seek to manage conflicts of interest that could lead to exploitation or harm. Psychologists consult with, refer to, or cooperate with other professionals and institutions to the extent needed to serve the best interests of those with whom they work. They are concerned about the ethical compliance of their colleagues' scientific and professional conduct. Psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.
Funny how one word can invalidate the rest of the sentence.
I'm pretty sure that's there because the principles aren't enforceable like the standards.
Similar, except the pro bono and sliding scale is only for the people working for me that are still getting training and supervised experience. I did some pro bono work when I was starting out but I’m pretty busy with running a business while maintaining revenue.Yes. Pro bono slots, sliding rate slots, and still earn very well.
Honest fella
I worked for free all through grad school - then got exploited during internship so....I paid my dues. I am very fiscally-focused. I run my practice just like any other business, whether they be selling clothes, food, etc. Each time slot has a certain value for me, so I make decisions based on multiple factors with $$ and time being my top two factors. Like Kevin and Mark say on Shark Tank "I don't get out of bed for X amount."Honest fella
Similar, except the pro bono and sliding scale is only for the people working for me that are still getting training and supervised experience. I did some pro bono work when I was starting out but I’m pretty busy with running a business while maintaining revenue.
Very creative!I have one pro bono slot (I call it a "scholarship" instead of "pro bono") open every 3 months; that patient has the option to "graduate" to sliding scale afterwards. It is time limited and not session limited, so if they miss 4 weeks of sessions they don't get to extend.
Thank you! I approve of yours as well.@msc545, I just noticed your signature line and I approve 🙂
This. Occasionally I have clients who switch into medicaid, and I typically see them for free for a while until they can get back on the exchange. Medicaid is nigh impossible for a solo practitioner. It's so much worse than Medicare, so it doesn't have to be this way, but it is.Any Medicaid work I do is pro bono, since I don't even bother with the billing - simply too much hassle for too little pay.
This. Occasionally I have clients who switch into medicaid, and I typically see them for free for a while until they can get back on the exchange. Medicaid is nigh impossible for a solo practitioner. It's so much worse than Medicare, so it doesn't have to be this way, but it is.
The public feels bad for "old people" and wants them to have things. No one feels bad for "poor people". I don't imagine it will change any time soon. Bootstraps and all that.
Issues are twofold here between reimbursement and bureaucracy. Reimbursement will be highly dependent on state. But the paperwork burden is fairly universal here. Medicare is just easier all around to deal with than most payors. Medicaid can pay similarly in some states, but all of the admin burden eats into your time/reimbursement ratio there.
Rates are not great for medicaid testing with children, relative to some commercial insurers and- especially- what you could charge private pay. I make up for that in volume, and am also a "value added" service to my parent agency (which is primarily an ABA provider). My salary is augmented by teaching in an affiliated graduate program. I aim to (and usually succeed) in covering my annual salary plus 25% in billable services, but that involves a lot of testing. Across the entire group of psychologists, there are some years where we barely break even (or don't) and the testing services are subsidized by the other services in the agency (which, granted, could not operate without children diagnosed with ASD, and in some areas of the state we are the only ones doing those diagnostic evals). It would be financially difficult to operate a stand alone toddler testing clinic that primarily saw medicaid clients.None of the states I have been in reimburse anywhere close to even Medicare. The paperwork is worse and the billing more restrictive, especially for treatment reimbursement. I know that @ClinicalABA does alright on the child side.
Medicaid (Called MediCal here in CA) is just laughable relative to going rates. Even worse, the paperwork burden is terrible and I am unwilling to do it myself or to hire anyone to do it for me given the very low reimbursement rate for Psychologists. Lastly, if you happen to get caught up in one of their draconian audits, that alone will make you wish you had never billed them.Issues are twofold here between reimbursement and bureaucracy. Reimbursement will be highly dependent on state. But the paperwork burden is fairly universal here. Medicare is just easier all around to deal with than most payors. Medicaid can pay similarly in some states, but all of the admin burden eats into your time/reimbursement ratio there.
I had MediCal as a child.Medicaid (Called MediCal here in CA) is just laughable relative to going rates. Even worse, the paperwork burden is terrible and I am unwilling to do it myself or to hire anyone to do it for me given the very low reimbursement rate for Psychologists. Lastly, if you happen to get caught up in one of their draconian audits, that alone will make you wish you had never billed them.
The MediCal system is California is designed to accomplish two goals:
1. To discourage patients from trying to use it, and this works fairly well when they discover that their are relatively few providers that will accept it.
2. To discourage providers from accepting it for all of the reasons I have previously mentioned. The system is 95% unusable, and if you do try to use it you will be discouraged immediately by the number of ridiculous hoops you have to jump through just to even get credentialed.
Unfortunately, as has been said, this is the case with Medicaid in many states. It's often easier (in terms of time, money, and sanity) just to see the cases pro bono.When it costs more to bill MediCal than the amount you get reimbursed, most people stop accepting MediCal patients and stop trying to bill it.
Yes, exactly. It is not an accident that these systems are so difficult and costly for providers to use. They were designed that way because the entities that supposedly fund them want to spend as little money as possible.Unfortunately, as has been said, this is the case with Medicaid in many states. It's often easier (in terms of time, money, and sanity) just to see the cases pro bono.