Parker and Tom discuss how patient-provider communication in mental health care has changed over the past 30 years, from pagers all the way to AI.

Provider-patient communication outside of session can affect multiple sectors including the clinical relationship, patient experience, boundaries, and operations, so we found it extremely relevant to dive into how much the dynamic has changed as a result of technology.

When should a growing mental health practice start offering employee benefits?

In this episode, Parker and Tom discuss how practice owners can think about PTO, health insurance, retirement plans, disability insurance, and other benefits without overextending the business.

They also cover how benefits affect recruiting, retention, budgeting, and the shift from 1099 contractors to W2 employees.

0:00 Introduction

4:00 At what point should a practice owner consider providing employee benefits?

9:28 What are the best employee benefits to provide, and what are required?

16:55 What can you tell us about health insurance employee benefits?

24:30 What are some unconventional employee benefits that are worth mentioning?

30:57 How do mental health practice owners procure and provide employee benefits?

32:32 What common mistakes do practice owners make when providing benefits?

39:11 Is there anything else you want to mention about employee benefits?

41:09 A word from Rai

42:05 The Mental Health Business Moment

45:23 Conclusion

Nearly two decades after federal mental health parity law passed, why is access to care still so difficult?

In this episode, we break down how insurance rules, low reimbursement rates, ghost networks, and weak enforcement continue to limit mental health care access. We also discuss Illinois’ new behavioral health legislation, including a minimum commercial insurance reimbursement floor tied to Medicare rates.

0:00 Introduction

3:00 What is mental health parity law?

7:56 Why do many barriers to care still exist when there are parity laws?

13:46 What are some real-life examples regarding parity laws?

30:36 What else is important to understand about parity laws?

34:24 A word from Rai

35:10 Mental Health Business Moment

44:22 Conclusion

This week, we discuss why mental health clinicians should pay attention to legislation, insurance policy, and mental health parity laws. Tom explains how federal and state laws can directly affect access to care, reimbursement, authorization requirements, and a provider’s ability to deliver clinically appropriate treatment.

We also cover the Mental Health Parity and Addiction Equity Act, state-level protections, Medicare’s influence on commercial insurance, and why providers may need to get more involved in advocacy when policies threaten patient care.

0:00 Introduction

2:31 Why should clinicians care about legislation regarding mental health?

7:00 What past example do you have of legislation affecting your care for patients?

16:55 How much does access to care depend on the policies surrounding mental health?

22:44 What should clinicians be paying attention to when a new law or policy is proposed?

27:45 A word from Rai

28:27 Mental Health Business Moment

30:11 Conclusion

We return for part two of our conversation on how insurance barriers affect mental health care. We discuss the fight for single case agreements, ghost networks, delayed approvals, and why these systems can leave patients without the care they need even when the rules are supposedly on their side.

This episode also explores how insurers create friction for providers, why continuity of care becomes so hard to protect, and what it looks like when a clinician keeps pushing anyway.

0:00 Introduction

5:29 Frustrating insurance incident

10:17 Single case agreement battle

38:44 A word from Rai

39:28 Mental Health Business Moment

40:31 Conclusion

Insurance companies keep finding new ways to make mental health care harder to provide and harder to access.

In this episode, we break down frustrating new tactics affecting psychiatrists, therapists, and patients, from stricter psychotherapy billing requirements to misleading out-of-network reimbursement practices.

We also discuss why these changes matter, how they can push providers away from accepting insurance, and why the fight over mental health coverage is far from over.

0:00 Introduction

5:18 What insurance company-based incident pushed you over the edge?

12:58 Does some fault lie with providers for the broken insurance system?

16:50 What is another example of a frustrating insurance company-based incident?

24:14 Is there a unique trend in mental health where most providers are out-of-network?

32:06 Raiminder

32:53 Conclusion

Tom breaks down the hard conversations friends and partners need to have before starting a mental health practice together. We cover ownership, leadership, profit, long-term goals, and how to handle disputes before they become real problems. If you’re thinking about going into business with someone else, this episode is a strong reality check.

0:00 Introduction

4:43 What are some expectations partners need to align on before opening a practice?

9:38 How can partners in a practice decide who will run the clinic's operations?

12:03 How can disagreements between partners be resolved effectively?

15:43 What are the different roles and titles that partners in a company can assume?

18:18 What happens when one partner starts underperforming on obligations?

23:02 How well should you know someone before partnering with them?

28:03 What are some key points to discuss as partners before starting a practice?

29:20 A word from Rai

30:00 The Mental Health Business Moment Of The Week

33:25 Conclusion

How do you start a psychiatry practice and make insurance work?

Child psychiatrist David Balyozian joins us to discuss how he built an insurance-based child psychiatry practice from the ground up. We cover negotiating reimbursement rates, building referral networks, managing multiple roles, and growing a practice while keeping access to care at the center.

Along the way, David makes the case that insurers’ “final” rates are often anything but final.

Many mental health providers who accept insurance don’t actually know their contracted reimbursement rates.

In this episode, we explain what a fee schedule is, why so many clinicians don’t know their rates, and how this can lead to underpayments, billing errors, and poor financial planning.

0:00 Introduction

2:41 What is a fee schedule, and why do they matter?

6:31 Why don't providers often know the rates they have with insurance companies?

9:53 Can providers assume the payouts by insurance will be reliable?

15:14 How can providers check to see if their insurance rates are being honored?

22:52 What do practices need to provide to patients regarding insurance rates?

26:49 What's your perspective on the ecosystem of taking insurance as a provider?

30:03 Conclusion

We’re joined by Sarah Dosanjh (MSc, CTA, MBACP), a UK psychotherapist specializing in binge eating recovery, to talk UK vs US private practice, ethical self-disclosure, sustainable marketing through YouTube, and what GLP-1 weight-loss injections may mean for eating-disorder treatment going forward.

0:00 Introduction3:01 What inspired you to pursue a career in the mental health field?6:31 Do you face challenges when sharing your personal journey online?9:34 Are you exclusively working with eating disorder clients?11:20 What's it like starting a private practice in the UK?21:15 Why do you advertise your service to clients all over the world except the US?26:25 How have your marketing strategies affected the success of your practice?31:21 What is your preferred balance of time for patient care versus business operations?35:58 What would you change about the state of the mental health field?42:55 What does therapist documentation look like in the UK?46:16 Conclusion