WP185 | Billing Without Guilt: Creating a Cancellation Policy That Works with Beth Rontal, LICSW
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Y’all ever feel that little knot in your stomach when it’s time to talk about money with a client?
Like you know, you’re called to this work… but charging for it still feels uncomfortable?
In this episode, I’m sitting down with Beth Rontal, a clinical social worker and documentation expert who has helped thousands of therapists turn their clinical work into clear, compliant notes that actually protect their practice and their income. But what we really get into is something so many of us wrestle with and don’t always say out loud… the guilt around getting paid.
We talk about why that guilt shows up, especially for those of us who see this work as a calling, and how to shift your mindset so you can serve your clients well without burning yourself out in the process.
Beth also shares practical, real-world strategies around cancellation policies, no-shows, and getting paid in a way that’s both firm and relational. Y’all, this is the kind of conversation that can change how you run your practice day to day.
If you’ve ever struggled with setting boundaries, enforcing your policies, or just feeling confident asking for what your time is worth, this one’s for you.
Y’all, Let’s Talk About the Guilt Around Charging
I hear this all the time from practice owners, and if I’m being honest, I’ve felt it too. You’re called to this work. You care deeply about your clients. You believe in what you’re doing. And then comes the moment where you have to talk about money, enforce a policy, or charge a fee… and suddenly it feels uncomfortable.
There’s this tension we carry. On one hand, we want to serve people well. On the other hand, we’re running a business that has to sustain us, our families, and the clients we’re trying to help. And somewhere in the middle, guilt sneaks in and starts making decisions for us.
When You Avoid Policies, You’re Still Making a Decision
A lot of practice owners think they don’t really have a cancellation policy problem. But when we start talking through it, it becomes clear real quick. You didn’t charge that late cancellation. You let that no-show slide. You gave grace… and then gave it again… and again.
And before you know it, you’ve trained your clients that your time is flexible, optional, and honestly, not that valuable.
Y’all, that might sound harsh, but it’s the reality. When we don’t enforce what we say matters, we’re still communicating something. And usually, it’s not what we intended.
This Isn’t Just Business… It’s Clinical
One of the biggest mindset shifts that changed everything for me is realizing this isn’t just about money. This is clinical work.
When you set a clear policy and stick to it, you are modeling boundaries. You are teaching consistency. You are showing your clients what it looks like to make an agreement and honor it.
That’s not separate from therapy. That is therapy.
So when you feel that hesitation rise up, I want you to remember, you’re not just protecting your schedule. You’re creating structure and safety for your clients.
You’re Not Getting Paid for the Session… You’re Getting Paid for Your Time
This one right here is a game-changer.
We tend to think we’re getting paid for what happens in the session. But the truth is, you’re getting paid for your time. That hour you reserved? You don’t get that back.
When a client doesn’t show up, it’s not just a missed conversation. It’s time you held… the energy you prepared… and the space you protected that now goes unused.
And if that keeps happening, it starts to affect your ability to show up fully, not just for one client, but for all of them.
Why Your Cancellation Policy Needs to Be Clear and Enforced
It’s not enough to have a policy written down somewhere in your paperwork. Your clients need to understand it. They need to hear it from you. And they need to experience that it’s actually real.
That means saying it clearly, explaining why it exists, and following through when it’s tested.
I know that’s the hard part. Because we want to be liked. We want to be understanding. We want to be flexible.
But when we bend every time, we create confusion instead of care.
What Actually Counts as an Emergency
This is where things can get a little gray, and honestly, where a lot of therapists get stuck.
Because yes, there are real emergencies. And we want to respond with compassion when those happen.
But not everything qualifies.
A hospital visit, a car accident, something truly unexpected… those are emergencies. A meeting, a headache, or just not feeling up to it… those are not.
When you define this clearly ahead of time, it takes some of the pressure off in the moment. You’re not making an emotional decision. You’re following an agreed-upon structure.
Grace vs. Consistency
I get asked all the time about giving a “grace session.” Letting the first one slide. Making exceptions here and there.
And here’s the truth… you get to decide that.
But you also need to be aware of what it communicates.
If you say one thing and do another, your client is going to notice. And over time, that inconsistency can start to show up in other areas of the work too.
Consistency builds trust. Even when it feels uncomfortable in the moment.
Stop Chasing Payments After the Session
Y’all, if you’re still trying to collect payments after sessions, I want you to take a hard look at that process.
Because what ends up happening is you’re spending time tracking people down, running cards later, dealing with declines, and having awkward follow-ups that don’t feel good for anyone.
And from the client’s perspective, getting charged days later out of nowhere? That doesn’t feel great either.
When you move payment to the beginning of the session, everything changes. It’s clean. It’s clear. And it removes that lingering stress on both sides.
You Can Care Deeply and Still Hold Boundaries
This is really what it comes down to.
You can be compassionate, relational, and deeply invested in your clients… and still have firm boundaries around your time, your policies, and your income.
Those things are not in conflict with each other.
In fact, when you hold them well, they support each other.
And y’all, when your practice is sustainable, when your systems are clear, when your boundaries are solid… you show up better.
Not just as a business owner, but as a therapist.
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Meet Beth Rontal, LICSW
Beth Rontal LICSW, did not set out to become The Documentation Wizard. She spent 20 years as a theater costume designer before answsering a higher calling to become a trauma therapist. For over two decades, she has helped thousands of therapists transform their clinical intuition into clear, compliant documentation that passes audits and protects both client confidentiality and therapist income. She developed these skills while supervising clinicians and helping to create a mental health clinic's first digital documentation system. As a nationally known documentation expert, Beth's trainings, forms, and consultations provide structure and clarity that translate clinical work into notes reflecting high-quality care. She continues to maintain her clinical practice in Boston, MA.
Beth’s Resources
Get Paid Without the Guilt – 13 Practical Tips for Psychotherapists to Protect Their Income
Links and Resources
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[00:00:00] Whitney Owens: If you already have a website and some marketing in place but aren't seeing the results you've expected, it might be time to take a closer look at your SEO strategy. At Simplified SEO Consulting, they offer personalized consulting packages designed to help practice owners understand what's working, what's not, and exactly what to do next.
Whether you need help with keyword strategy, content planning, or improving your search visibility, they guide you step by step so you can make confident informed decisions. So right now they're offering 10% off their SEO consulting packages. For listeners of this podcast, this is a great option. If you want an expert insight without committing to a full service plan.
So to get started, head on over to simplified seo.com. Hi, I'm Whitney Owens. I'm a group practice owner and faith-based practice consultant, and I'm here to tell you that you can have it all. Wanna grow your practice, wanna grow your faith? Wanna enjoy your life outside of work, you've come to the right place.
Each week on the Wise Practice Podcast, I will give you the action steps to have a successful faith-based practice while also having a good time. Now let's get started.
[00:01:11] Jingle: Where she grows your practice and sheet on. She does business with a twist of faith. It's Whitney Owen and Wise Practice Podcast, Whitney Owen and Wise Practice Podcast.
[00:01:30] Whitney Owens: Welcome back to The Wise Practice Podcast. I'm so glad that you're here with me today. Today's conversation is one that many practice owners wrestle with. And honestly avoid cancellation policies, right? We feel so much guilt, confusion about it, and it's so important that we create a policy that's really effective and works not just financially, but also to benefit our clients to help them understand.
What we're enacting. I mean, that's important, but it's also clinical in nature. 'cause on one hand, you know you need a cancellation policy because it impacts your time, your energy, your sustainability of your practice. And if you don't have it, you wouldn't be able to get other clients in the door. When someone cancels, you need to know that they're not coming.
But on the other hand, there's a tension because we care deeply for our clients. We wanna understand them. And make the most of our time with them. But we also feel all this guilt, right? Can you hear me? You know, guilt over, am I really gonna charge that? Am I really gonna enforce that? Is that really what's best for the clients?
So then what happens is. You leave money on the table. Now, a lot of people don't realize they're doing it, but they do. And I talk to practice centers pretty consistently, and I'm like, why didn't you charge the cancellation policy? And then when they start thinking about it, they're like, oh, I guess I should have, right?
We get emotional as therapists. We care for our clients, we know their stories, but it's so important that we charge that because we are running a business. And if your business isn't thriving, you're not gonna be able to serve more clients. So we've gotta create a consistent. Policy that works for us and works for our clients that we're very direct about.
So in this episode, I'm joined with Beth Ronal, who really digs into cancellation policies, documentation, paperwork that supports your business without compromising your values. So we dive into kind of the practical side of all this, what to put in place, how to communicate it, what are good boundaries, when to charge and not charge.
We wanna create safety and consistency for our clients. So if you've struggled with this or maybe you have a cancellation policy and you're trying to like figure out if this is gonna work for you, you're gonna learn a lot in this episode. So make sure that you stay tuned for that. And I wanna put in a quick plug here before we get going about the call to More Mastermind led by Laura Long.
She's one of the Wise practice consultants. That Mastermind is gonna start the month of June because. June is a really good time to start working on passive income. Other things that you feel called to outside of sitting in the therapy chair. Laura has worked with thousands of practice owners and helped them learn what is it that I feel called to and how am I sensing God's presence in this?
And then how do I actually put this thing in the practice? So she'll help you figure out, is this the thing that I should be doing? Can I make money off of it? Is this how God is directing me? How will this impact the kingdom? But also step-by-step instructions on how to actually implement. So to learn more, head to wise practice consulting.com.
Um, we are doing an early bird that ends May 15th. So if you're thinking about joining, go ahead and make sure that you jump in on that and you can find all that information on the website, fill out an application, and then we'll be in touch with you again. Thank you for listening to the podcast. Looking forward to introducing you to my new friend Beth.
Today on the podcast I have my new friend, Beth Reell. She is a clinical social worker. Did not set out to become the documentation wizard though she spent 20 years. As a theater costume designer before answering a higher calling to become a trauma therapist for over two decades, she's helped thousands of therapists transform their clinical intuition into clear compliant documentation that passes audits and protects both client confidentiality and therapist income.
She developed these skills while supervising clinicians and helping to create mental health clinic's first digital documentation system As a nationally known documentation expert, Beth's training forms and consultations provide structure and clarity that translate clinical work into notes reflecting high quality care.
She continues to maintain her clinical practice in Boston. Welcome to the show.
[00:05:50] Beth Rontal: Thank you. I'm very happy to be here.
[00:05:54] Whitney Owens: Yeah. First, I thought that was super interesting that you did costume design.
[00:05:59] Beth Rontal: I spent 20 years in the theater and I loved it, and you know, but if therapists think finding clients is hard, making it in the theater is a lot harder.
[00:06:11] Whitney Owens: Oh,
[00:06:11] Beth Rontal: that's, and after 20 years, I said, I think it's time for a change.
[00:06:17] Whitney Owens: Yeah. Yeah.
[00:06:18] Beth Rontal: And it's been a great change for me.
[00:06:21] Whitney Owens: Wonderful. Well, the therapist world is glad to have you.
[00:06:25] Beth Rontal: I was a good designer. I'm a better therapist.
[00:06:29] Whitney Owens: Wonderful. Well, so you have your own practice in Boston. Can you tell me a little bit about that?
And then we're gonna talk more about fees and guilt. So tell us about your practice.
[00:06:39] Beth Rontal: I work with people who struggle with emotional eating. I wouldn't say I work with eating disorders, although I certainly have have plenty of that. But I really work with people who struggle with emotional eating, people who want bariatric surgery, people who need to prepare for bariatric surgery, people who have failed at bar bariatric surgery.
Um, and what comes with that is often trauma.
[00:07:10] Whitney Owens: Hmm mm-hmm.
[00:07:11] Beth Rontal: Because people eat to stuff their feelings. And what are those feelings and how did they get there? And I also do work with early mother loss because that was my own experience.
[00:07:25] Whitney Owens: Oh yeah.
[00:07:27] Beth Rontal: So
[00:07:30] Whitney Owens: you are correct on all fronts. I definitely am an emotional eat.
[00:07:35] Beth Rontal: Truly. If we took a poll of most of the women in the United States, most of us would come up as emotional eaters and men too. Yeah. It's just, is that the only thing that you use Sure. To cope with your emotions?
[00:07:51] Whitney Owens: Definitely. Great.
[00:07:53] Beth Rontal: It can't be the only thing.
[00:07:54] Whitney Owens: Yeah. Well you, well, you're certainly doing important work there.
And as you just said, it's something that is very common in our world needing assistance. Yeah. So, yeah. Well, today we're gonna talk about this topic of getting paid without feeling guilty.
[00:08:10] Beth Rontal: Yeah.
[00:08:10] Whitney Owens: And before we got on, we were talking specifically about. I mean, I think a lot of therapists feel guilty 'cause we're in the helping field, but particularly Christian counselors have this like extra level of guilt because faith in what we do, it's a calling.
Like even when I started my practice, I was like, I feel called to this work. God's with me. This is my mission in the world. How could I possibly charge a client? For doing ministry, basically. And so let's kind of start there, maybe tips, thoughts that you have about that.
[00:08:41] Beth Rontal: I think that is a widely held belief by many, many, many therapists.
It's a calling and how can I possibly charge and I have to be able to take care of everyone, anyone who needs me, and, and I understand it. Because for me, being a therapist was a calling Uhhuh. Um, what I also know is we cannot participate in our calling in what we are truly passionate about and feel drawn to if we don't make a living doing it.
We are, we, we are not in an organization that pays us to live so that we can give away our service. We have to get paid and, and we're in a high risk profession.
[00:09:30] Whitney Owens: Yeah.
[00:09:32] Beth Rontal: So we have to be mindful of that and careful about that. We think we get paid for our service, but what we really get paid for is our time.
Every hour we show up is another hour of our time that we never, ever, ever get back. And what do we wanna do with that hour? Well, when this is a calling. This is what we wanna do and when people don't show up, we don't get paid for it. So the first thing I really recommend is that people have very clear cancellation in late and late cancel and no-show policies.
Um, I know that when I was a young therapist before I went out on my own, I worked in a clinic and even though we did home visits. Their clients would just not show up to their house. They would or they wouldn't answer the door. And I had a supervisor when I asked him, how do I know when it's time to discharge someone?
He said, whenever you want. He was kind of letting me learn by my own mistakes. It was actually the wrong thing to tell me for a couple of reasons. One is every time this particular client didn't show up, I didn't get paid and I had spent my time, my gas, my emotional energy waiting to see her because if I could just see her, I know I could make a difference.
[00:11:17] Whitney Owens: Oh yeah.
[00:11:18] Beth Rontal: That's what we bring to our work. This incredible deep commitment to helping people transform their lives. And that's where our faith is. We can do this. This is a calling, but they have to show up and if they don't show up, I repeating this a lot. We don't get paid. And then we can't do our work.
And we are in that high risk profession where we take on people's emotional pain, we take on their troubles, even though we're not supposed to. When you care about someone, you become very invested. And we do care about our clients.
We wonder all the time, how can we do better? What can we do to help them grow more? Well, we have to pay for trainings. We have to pay for groceries, our rent, our mortgage, and we have to pay for our time off. And we are the only ones who can do that if we're in private practice.
[00:12:27] Whitney Owens: Yeah.
[00:12:27] Beth Rontal: We are the only ones who pay for our sick time, our vacation time.
Our disability time.
[00:12:33] Whitney Owens: Yep.
[00:12:34] Beth Rontal: And if we can't do that, we can't serve the people we're called to take care of.
[00:12:41] Whitney Owens: Yeah.
[00:12:43] Beth Rontal: So, and, and the other reason that you can't keep a client on indefinitely when they don't show up is. If you haven't discharged them and something happens to them, you can be held liable.
[00:12:57] Whitney Owens: Yes,
[00:12:58] Beth Rontal: and nobody needs that.
[00:13:03] Laura Long: Hi, I am Laura Long, one of the consultants at Wise Practice, and over the past decade I've helped hundreds of therapists develop and launch their own programs, workshops, intensivess, and other income streams beyond the therapy room. If you've been feeling like God may be inviting you into a new season of growth or a greater impact, but you're stuck or overwhelmed on where to start.
You're not alone. The call to More Mastermind is a six month experience where we'll help discern your direction, design a simple first offer, and actually begin building it without burning out your life or your practice. If you're ready to move from thinking about doing it, to actually doing it, head over to wise practice consulting.com and apply today.
[00:13:43] Whitney Owens: So what do you recommend for a cancellation policy?
[00:13:47] Beth Rontal: Well, first of all, I recommend one that works for the individual therapist and then one that is clearly communicated and enforced. So the typical cancellation policy is 24 hours. I have a 48 hour cancellation policy because that's what works for me, and frankly, in 24 hours it's really hard to find somebody else to fill a slot.
It's hard to find somebody else in 48 hours as well. I am amazed. With 48 hours how often it can happen, but the 48 hours gives people real pause because they say, oh, I better think about this ahead of time. And I also recommend that people not charge a cancellation fee that's less than their regular fee.
Whether it's the private pay or an insurance fee, I recommend charging the entire amount. Because you would've gotten it had you had the session taken place.
[00:14:54] Whitney Owens: Yes.
[00:14:56] Beth Rontal: This is really hard for therapists to do because they want to be liked, they want to support their clients, and they don't think it's supportive.
To say, we have an agreement and this is the agreement, and I need you to honor the agreement. So what I recommend doing and what I did a lot when I was supervising for 11 years, when I, um, when my supervises would come to me with this issue, I, I just recommend going over the cancellation policy really carefully with people.
And letting them know this time is for you. No one else gets it. It is reserved just for you. I am completely committed to helping you do get out out of therapy, what you want out of therapy, and I have very few needs around that. You can show up however you want, but the one need that I have. To help you get what you want is to show up.
And if you don't, and I have a 48 hour cancellation policy, and I will charge you if you don't give me that 48 hours of notice because it's really hard to fill the slot. And I am the only one who can take care of my own personal lead needs, like sick time, vacation time, or any or emergency time. Mm-hmm.
And I'm really upfront about it.
[00:16:31] Whitney Owens: Yeah.
[00:16:32] Beth Rontal: And I know I'm sounding a little harsh at the moment and cut and dry, but I'm pretty relational when I do it, and I'm always looking for a client's response. To see how they're responding to what I'm saying, but they nod their heads. Now will they remember when they cancel late?
They may not, and I will remind them.
[00:17:00] Whitney Owens: Yeah, I don't think you sound harsh at all.
[00:17:03] Beth Rontal: Thank you. I
[00:17:04] Whitney Owens: think you sound, I think you sound very thoughtful about the way you say it. In fact, I'm sitting here listening, going, man, I'm not that nice when I say it. I'm like, 24 hours. That's it. Done. But you, the way that you're bringing in the therapeutic relationship, your humanity within having this conversation, I think is really powerful.
And our cancellation policy is a way that we are teaching and training people. We make an agreement, we keep our agreements, you know? That's right. It's important you steward it well, like you're teaching them all these things and hey, I make this space for you. I think that's such a loving way to present that to your clients.
[00:17:42] Beth Rontal: Thank you. It's modeling good boundaries.
[00:17:45] Whitney Owens: Yeah,
[00:17:46] Beth Rontal: and that's really important right from the beginning. I also tell them if there's an emergency, I'm not draconian. But then I lay out what an emergency is and what it isn't.
[00:18:00] Whitney Owens: Okay. I was curious about that. What?
[00:18:02] Beth Rontal: Oh yeah, and it's also written down, I mean, my cancellation policy, my, my informed consent's very thorough.
As you can imagine, because I'm the documentation wizard, right? Um, yeah, my cancellation policy is very thorough and, and I lay out what is and isn't an emergency. So what, you know, what's an emergency? Going to the hospital, a car accident, a death, but a meeting for your job is not an emergency. At least it's not an emergency on my end.
Um, what
[00:18:36] Whitney Owens: about sickness? What would you say about that?
[00:18:38] Beth Rontal: Um, it gets a little gray. There are times when I give a client a choice. You know, if they're really sick, they're not gonna participate well in therapy, but I do. A lot of, all of my therapy at this point is virtual, but even if you do in-person therapy, you can have the option to do virtual.
So. Um, I will ask them, are you well enough to, to do a virtual session if they are sick? And it's really clear to me that they have been sick, I charge them.
[00:19:14] Whitney Owens: Mm-hmm.
[00:19:16] Beth Rontal: They were sick, but they didn't think to tell me until the night before.
[00:19:21] Whitney Owens: Yep.
[00:19:23] Beth Rontal: No, I'm nice about it. They'll say, well, it's okay. You know, charge me if you have to.
Yeah. Thank you. I do.
[00:19:34] Whitney Owens: It's interesting. I, I have a couple of stories I'd love to, to share and talk about. Um, my clinical supervisor here at the practice, we had a conversation about cancellations and she said. You know when people were sick, I used to not charge them, she said, but then I was, it was happening a lot, so I started doing it.
I started saying kinda what you just said, like you knew the night before. You knew before this morning. And she said, once I started doing that, it was amazing how many people weren't sick anymore.
[00:20:02] Beth Rontal: Yeah, yeah, exactly. I mean, I also tell people a headache is not a reason to not come. It could be that you're getting a headache because you are coming.
Yes. Picking up a sick child from school, that's an emergency.
[00:20:18] Whitney Owens: Mm-hmm.
[00:20:18] Beth Rontal: Right. That happens. You have to kind of play it by ear. There are some people who say cancel is, cancel charge 'em.
[00:20:27] Whitney Owens: Yeah.
[00:20:27] Beth Rontal: But I also tell people if we can reschedule before your next set planned session, I will. And if we can't, you'll know.
I've tried.
[00:20:41] Whitney Owens: Yeah.
[00:20:42] Beth Rontal: And I do try, because I tell them I don't like to charge somebody for something they didn't get. But I do need to if we can't reschedule.
[00:20:52] Whitney Owens: That's right. Because we, I mean, money is great, but we do this work 'cause we wanna do the work.
[00:20:59] Beth Rontal: Mm-hmm.
[00:21:00] Whitney Owens: I'd much rather the clients show up and get paid than them not show up and get paid.
'cause I actually get better.
[00:21:06] Beth Rontal: That's right.
[00:21:07] Whitney Owens: Yeah. You know, it's interesting, Beth, I had one therapist. Now there were some other things about this lady. That is the reason I stopped seeing her. I only went to two sessions. She did E mdr R. Mm-hmm. And I dunno, E MDR R, but boy, I ran it by an EMDR therapist later and she was like, they ain't good in MDR.
So there was some things going on.
[00:21:25] Beth Rontal: Yeah.
[00:21:26] Whitney Owens: But one morning and sh I had to drive to see her an hour and a half. So, I mean, or it was an hour because I didn't wanna see a therapist in my town, you know, about your trauma, I mean, you know, to practice. Um, but I woke up one morning with terrible pain, like stomach pain.
I was like, there's no way I can get in this car and drive, like I was doubled over. So I texted her third session, I texted, I said, I'm so sorry, I cannot drive. And she didn't, virtual wasn't an option. Um, especially 'cause of the state lines and stuff. She was in another state and she was like, I have to charge you.
It was three hours. 'cause it was, um, you know, in the, I don't know what you call it, oh, two to three hour EMDR. So she charged me several hundred dollars and I was like, wow, that was really intense. And I really did wake up this morning and I really was that sick. And that was the, I never went back after that.
Anyway, it's just interesting, like to get on the other side of an experience, right? 'cause we're as therapists, and I agree with everything you're saying, and I do the exact same thing, but then I was on the other end of it thinking, huh, I wonder what this experience is like for her. And now I'm the client.
Um, but it really impacted me that there was no like grace about the experience. Um, and I do think it's a little different having to go really far and having to have a long session as opposed to. Being able to do it from home and being on a virtual session for 45 minutes.
[00:22:50] Beth Rontal: Yeah, that's a, that's a real hard one because that therapist would learn, lose three hours of income.
[00:22:56] Whitney Owens: I know.
[00:22:57] Beth Rontal: And you know that that's where it becomes a real professional and clinical decision.
[00:23:04] Whitney Owens: Yeah.
[00:23:05] Beth Rontal: And where some people, probably mostly attorneys would say, have a policy and stick with it, period.
[00:23:12] Whitney Owens: Mm-hmm.
[00:23:13] Beth Rontal: Because when you start messing with your policies, somebody can,
[00:23:21] Whitney Owens: oh
[00:23:21] Beth Rontal: yeah, it could come back to bite you.
[00:23:24] Whitney Owens: So a lot of therapists will tell me, I have a grace session, so I let them have grace the first time that they cancel. What do you think?
[00:23:36] Beth Rontal: I think it's up to the therapist.
[00:23:39] Whitney Owens: Yeah,
[00:23:40] Beth Rontal: I have charged for the first time someone cancels
[00:23:43] Whitney Owens: me
[00:23:43] Beth Rontal: too.
[00:23:44] Whitney Owens: I mean, I, I, I guess to me, I feel like if I'm gonna say to somebody, this is the cancellation policy, and then it happens and I don't cancel, what does that say about other things that I say?
[00:23:55] Beth Rontal: I think that's a really good point's. Tough but
[00:23:57] Whitney Owens: important.
[00:23:58] Beth Rontal: If you say in, in an emergency, I will not charge you. But then somebody comes, just calls up and says, I have to cancel. That doesn't sound like an emergency. You know, for me, a headache is not an emergency. Wanting to do something different that day is not an emergency.
[00:24:18] Whitney Owens: Mm-hmm. Yeah. Yeah. Well, um, are there any, um, regards to insurance, like to think about? I mean, I know with certain insurances you can't charge a cancellation, and how do we like handle that?
[00:24:30] Beth Rontal: Well, for Medicare and Medic, no, for Medicare, you can charge for Medicaid. In most states, at least in Massachusetts, you can't, I don't know about other state laws.
Um, and you can charge, but you can't charge your private fee. You can charge what the insurance company pays, and I tell them that. I tell people it won't be your copay. It'll be the entire fee.
[00:24:59] Whitney Owens: Yeah. And so you, you're talking about being the documentation wizard. Do you have your cancellation policy somewhere that people can see or purchase?
[00:25:08] Beth Rontal: I have a very complete informed consent.
[00:25:12] Whitney Owens: Yeah.
[00:25:13] Beth Rontal: And in fact, I wrote up an informed consent that people can get off my website and it's written for national standards, but we have state standards. So there's these wonderful orange that, not orange yellow blocks in the consent that say, check your state standards for this.
It's very thorough, reviewed by. Two attorneys a bioethicist. It doesn't cover just cancellation fees, it covers confidentiality. I have one for couples and that covers, really covers issues of confidentiality and that are different than individual therapy. So at there's a saying that good fences make good neighbors good informed consents.
Make a good working is the beginning of a good working relationship.
[00:26:08] Whitney Owens: Yeah, that's great. Um, I have another question for you, kind of talking about money and guilt. You know, a thing that comes up for me that I hear from practice owners is collections and sending clients to collections. I don't know if you have ever done that or thought about it or have advice about it, but any thoughts on that?
[00:26:27] Beth Rontal: I have not done it. I have made the mistake of letting people go for too long without paying.
[00:26:35] Whitney Owens: Okay.
[00:26:36] Beth Rontal: And then they get upset with therapy and decide to drop out.
[00:26:40] Whitney Owens: Mm-hmm.
[00:26:40] Beth Rontal: And then they don't pay. And then I do have an attorney send a letter.
[00:26:45] Whitney Owens: Yeah.
[00:26:46] Beth Rontal: But they don't pay. And I don't take them to small claims court.
I never let it get that big.
[00:26:53] Whitney Owens: Huh.
[00:26:54] Beth Rontal: But I, I, it's just. Which, so that's why I recommend get payment before the session starts. When I had an office, people handed me a check as they walked in.
[00:27:07] Whitney Owens: Yep.
[00:27:08] Beth Rontal: I remember that. That was so nice. Uhhuh. And there are other therapists who, who say, pay me for the month. We're gonna put it on your credit card.
They get permission to use the credit card. They, which you need, and. Pay me for the month, and if you miss a session, we will just apply it to the next month. And other people who say you need to make a payment into this account before every session, I really think it's much better to get payment before the session starts then.
At the end, and I even have, I say this in my initial conversation, and I, it's in my informed consent payment is expected at the beginning of the session or once a month or however that the, it works for that therapist or how they choose to create the relationship with the client.
[00:28:12] Whitney Owens: Mm-hmm.
[00:28:12] Beth Rontal: Um, and I explained, I said, I don't want you thinking about money when you're walking outta here.
I want you to be thinking about the work that we just did.
[00:28:23] Whitney Owens: Aw, that's a good, that's a good way to say it.
[00:28:25] Beth Rontal: Thank you.
[00:28:26] Whitney Owens: I love how you're so therapeutic. We actually just changed our policy on this. I own a group practice here in Savannah. Yeah, of course. Any change is big change when you're changing it for a lot of people.
But we were running, ours is so not therapeutic. We were just running payroll and it was getting hard to run payroll because so many. Payments had not come through, or we would follow up after the session and try to charge a card and the card would be declined. So then in payroll time, we're calling up people to get those cards.
And of course, you know, you see. The practice calling. You don't wanna answer it, you know, they're calling to get your credit card, so then they don't answer it. So it's so much easier for the therapist to get the payment, you know, it's, it's therapeutic experience as opposed to getting a call from the admin.
But, so we told the therapist, we're gonna, we want you to start charging at the beginning. And of course it was, you know, there's some scaredness, you know what if I offend somebody? We're talking about money at the beginning. I'm like. This is part of therapy. You should be talking about money. They're paying you for this service.
So we started charging at the beginning as soon as they arrive. And, uh, it's been great. And, and what's really awful is I said this to 'em when a, when a client, when their car doesn't get charged and they're getting charged a week later, 10 days later when payroll gets rolled, that's not good either. No one wants to be charged a hundred dollars, $150 when they weren't planning on it.
And so then they call the office and say, why is Water's Edge charging me? I didn't have an appointment today. Well, it's for your appointment last week, sir, that you know, we never charged you for. That's not good for clients.
[00:30:00] Beth Rontal: Yeah, it's not.
[00:30:03] Whitney Owens: So we've changed that. But it was getting to the point of we'd have 30, 40 cards that needed to be run.
And you know, for all the therapists that's one or two clients to them, that's not a big deal. But when it becomes. A whole bunch of us. I'm like, that's somebody's salary that I can't pay because y'all didn't collect your payments. Um, so that made a big difference when we had that conversation of this is we're talking about thousands of dollars here, but even for you, you're thinking about one person.
[00:30:28] Beth Rontal: But even if they're thinking about one person, if it happens twice a month over 12 months, that's 24 times just on average. If it's a hundred dollars a session that they're missing. That's a lot of money.
[00:30:41] Whitney Owens: That's so much money. Yeah. Yeah. So now we charge at the beginning and it has gone so much better. And then we can address cards and issues at the beginning of session as opposed to at the end when everybody's worried or you're calling somebody afterwards.
Like the waste everybody's time. Yeah.
[00:30:59] Beth Rontal: Yeah. Good fences. Create good neighbors.
[00:31:04] Whitney Owens: I like
[00:31:04] Beth Rontal: that. It's really important to model good boundaries and to hold them kindly and firmly.
[00:31:12] Whitney Owens: Well, Beth, this has been so helpful. If people want to get in touch with you, get your tip sheet, what's the best way for them to do that?
[00:31:22] Beth Rontal: They can contact, first of all, they can go to my website, which is www documentation wizard.com. They can, uh, send an email to support at documentation wizard and get my tip sheet. You might have a link in your notes that they can click on and get, get my tip sheet.
[00:31:44] Whitney Owens: Well, this has been such a lovely conversation and it is truly been a pleasure meeting you.
[00:31:49] Beth Rontal: Thank you. Same here. Thanks so much for having me.
[00:31:55] Jingle: So click on follow and leave a review and keep on loving this work we do with Whitney Owens and The Wise Practice Podcast, Whitney Owens and The Wise Practice Podcast.
[00:32:14] Whitney Owens: Special thanks to Marty Altman for the music in this podcast. The Wise Practice Podcast is part of the Site Craft Podcast Network. A collaboration of independent podcasters focused on helping people live more meaningful and productive lives.
To learn more about the other amazing podcasts in the network, head on over to site craft network.com. The Wise Practice podcast represents the opinions of Whitney Owens and her guests. This podcast is for educational purposes only, and the content should not be taken as legal advice. If you have legal questions, please consult an attorney.
