WP175 | How to Get Insurance Companies to Raise Your Rates with Jeremy Hinote, LPC, NCC, CPCS
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What if your lowest-paying insurance panel is costing you thousands a year… and you didn’t even realize you could ask for a raise?
In this episode, I sit down with Jeremy Hinote, owner of Savannah River Counseling in Augusta, Georgia, to break down exactly how he negotiated a major reimbursement increase with one of the most notoriously difficult payers: Tricare.
And yes, it worked.
Jeremy shares the step-by-step process he used to:
• Identify his lowest reimbursement rate
• Research what others in his area were being paid
• Prepare a compelling renegotiation letter
• Push back (professionally) multiple times
• Secure a $20 per session increase
We also talk through the emotional side of the process. The fear of losing a panel. The tension between serving clients and running a sustainable business. And the mindset shift required to advocate for your value.
If you’re insurance-based, considering joining panels, or wondering whether you’re being underpaid, this conversation will give you practical tools and the confidence to start asking better questions.
Jeremy also shares specific resources, negotiation tips, and what insurance companies actually care about when reviewing rate increase requests.
If you’ve ever thought, “I guess this is just what they pay,” this episode may change your perspective.
You Can Ask Insurance Companies for a Raise
So many practice owners assume the rate they were offered is the rate they’re stuck with.
It’s not.
If you are credentialed with insurance, you can ask for a rate increase. And if you’ve never asked, you may be leaving thousands of dollars on the table every year.
That’s exactly what happened in Jeremy’s case.
He realized one of his panels was paying significantly less than the others. And like many therapists who left a group practice and credentialed quickly on their own, he signed a contract just trying to get on panel fast. He didn’t fully analyze what he had agreed to.
Once he slowed down and did the math, he saw the problem clearly.
His lowest payer wasn’t just slightly lower. It was dramatically lower.
And that changed everything.
Most Therapists Don’t Realize This Is an Option
When Jeremy started researching, he discovered something important.
You can renegotiate.
Many clinicians do not know this. They assume insurance panels are fixed and untouchable. But most companies allow renegotiation at certain intervals, often annually.
The key is knowing when and how.
With Tricare, for example, there’s a 90-day window before your contract anniversary when you can submit renegotiation requests. Other companies have different timelines. But there is almost always a process.
If you never ask, the answer is automatically no.
The First Step Is Identifying Your Lowest Reimbursement
Before you write a letter, before you call anyone, you need data.
Jeremy compared all of his reimbursements. He talked to other therapists locally. He looked at what others were receiving for the same insurance.
And he realized he was being paid less than someone a few miles away who wasn’t even fully in-network.
That is not a clinical issue.
That is a business issue.
As practice owners, we cannot avoid the business side. If your practice cannot sustain itself financially, you cannot serve anyone long-term.
Negotiation Is Both Strategic and Emotional
This process was not easy.
At the time, 40–50% of Jeremy’s caseload was Tricare. That’s high stakes. Walking away would have meant a major shift in revenue and client care.
The turning point came when he changed his mindset.
He had to become okay with the possibility of not being on the panel.
That doesn’t mean he wanted to leave. He deeply values serving military families. But he realized that negotiating from fear would not work. Negotiating from clarity would.
When he mentally prepared to walk away, he gained confidence.
And that confidence showed in his communication.
What He Included in His Renegotiation Letter
This was not a vague email that said, “Can you pay me more?”
It was strategic.
He outlined his credentials, years of experience, and clinical specialties. He highlighted the populations he serves and the volume of clients using the insurance. He explained how his current rate compared to other panels. He emphasized his commitment to serving that community.
He also did something bold.
He stated the rate he needed.
Not aggressively. Not with an ultimatum tone. But clearly.
Clarity matters.
Insurance companies are businesses. You are a business.
He Pushed Back More Than Once
The first response offered a very small increase.
Two dollars per session.
He declined.
They came back with a slightly better offer.
Still not enough.
He responded again.
On the fourth round of communication, they agreed to a rate that increased his reimbursement by about twenty dollars per session.
Twenty dollars per session adds up quickly.
Across weeks, months, and a full caseload, that is a significant financial shift.
The Ripple Effect Was Bigger Than Just His Own Pay
Because he was credentialed under his group tax ID, the increased rate applied to clinicians coming into the practice as well.
That means new hires were not starting at a suppressed rate.
That means the business structure improved.
This is what I want practice owners to see.
When you advocate for your rates, you are not being greedy. You are building sustainability.
Sustainability blesses your team and your clients.
You Must Balance Compassion With Stewardship
One of the most powerful moments in our conversation was when Jeremy described the internal tension.
He wanted to serve military families. He respects them deeply. But he also had to run a viable business.
This is where so many therapists struggle.
We feel guilty making business decisions.
But stewardship is not selfish.
If your margins are thin because of low-paying panels, you will eventually burn out or limit your growth. And then fewer people get help.
Your business needs to survive for your mission to thrive.
Be Careful Not to Join Too Many Panels
Another mistake I see often is over-paneling.
Therapists think more panels equal more access. But if you stack your practice with low-reimbursement insurance companies, you trap yourself.
If every new referral comes through your lowest-paying panel, your revenue ceiling drops.
Do the math.
Ask yourself what happens if your entire caseload is made up of your lowest payer. Can you sustain your expenses? Pay your clinicians fairly? Invest in growth?
If not, it’s time to reconsider your structure.
Sometimes, renegotiation is the solution.
Sometimes leaving the panel is.
But ignoring it is not.
When Should You Ask for a Raise?
In many cases, around the one-year mark is appropriate.
You want to show that you are actively using the insurance under your tax ID. You want volume and consistency behind you.
Then ask.
Put a reminder on your calendar to ask every year.
Even if they say no the first time, you’ve started the conversation.
What Insurance Companies Actually Care About
They are not impressed by generic statements like “I treat anxiety and depression.”
They are looking for differentiation.
Specialty areas like addictions, eating disorders, trauma work, and certain underserved populations can strengthen your case. Evidence-based approaches, outcome tracking tools like PHQ-9 and GAD-7, and licensure across multiple states all demonstrate value.
Volume matters.
Experience matters.
Data matters.
If you’re going to ask for more, you need to clearly articulate why.
Growth Happens Faster With the Right Support
Jeremy did not build his group practice alone.
He joined the Wise Practice Community early on. He engaged in mastermind groups at every stage of growth. He asked questions. He implemented. He showed up consistently.
And in less than two years, he moved from agency work to launching and expanding a group practice with multiple clinicians and a larger office space.
That kind of momentum doesn’t come from consuming information passively.
It comes from being in rooms where people challenge you, support you, and hold you accountable.
Show Up and Do the Work
There is a common thread I see over and over again.
The practice owners who show up consistently, who ask the hard questions, who face the numbers, and who take action are the ones who grow.
Not because they are the smartest.
Not because they hustle the hardest.
But because they are willing to steward both the clinical and business sides well.
If your insurance rates are lower than they should be, this is your nudge.
Run the numbers.
Do the research.
Have the conversation.
You might be one letter away from a significant shift.
Jeremy Hinote’s Resources
Links and Resources
Get my book, The Practice of Becoming
Join the Wise Practice Membership Community
Learn More about Wise Practice Consulting
Connect with Wise Practice on Instagram
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[00:00:00] Whitney Owens: Hi, I am 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.
[00:00:29] Jingle: Where she grows your practice and she don't play. She does business with a twist of faith. It's Whitney Owen and Wise Practice Podcast, Whitney Owen and Wise Practice Podcast.
[00:00:47] Whitney Owens: Before we jump into the episode, I just wanna share a little bit more about our guest, Jeremy Hinote, I think the world of Jeremy.
We met two years ago at a conference for practice owners. I remember our conversation so clearly. At the time, he was working at a large agency. I believe he had a manager position while also seeing clients. So he was doing very well for himself, but he had a passion to start his own practice. He had some fears, some excitement about that, and was really looking for.
A way to pull the plug and to start his practice, but also do it in a way that's sustainable and knowing how to make it personal to him, the passion behind what he was doing. And so as he's at the table talking about this with us, I'm thinking, wow, I would love for him to get involved in the Wise Practice community because we have so many resources and the ability to help him know the direction and the steps to take next.
So he took that step and became a part of the community at that time. Now, let me tell you a little bit of what's happened with Jeremy since. So he stepped out in faith. He left the agency work and he launched his own practice in Augusta, Georgia. He hired several therapists. He's built a group practice, and now he's preparing to move into a new building.
This is all in under two years. When you get the help that you need. And you do it alongside other people that are motivated, you can go so much faster and prevent so many costly mistakes. So growth like this doesn't just happen because somebody thinks I'm gonna try harder, I'm gonna listen to more podcasts.
Even though podcasts are great, ha ha. But it's not just getting the information. You can get the information, you can go on AI and someone can tell you what to do in your practice, someone as an ai, um, but. That doesn't really do it right. You need someone who understands you personally. You need someone who's done the work, who's been there, and you need a community to do it alongside you if you really want to grow more quickly, if you really want to have success.
So it happens when you're in rooms where people are challenging you, where they're supporting you, and they're giving you that practical strategy. So this is why we created the Wise Practice Community. I know what it's like to carry the weight of leadership. I've been there, I've done it, and now I do it with a group of other practice owners.
In the faith-based community of wise practice, we know what it's like to wonder if you're making the right decisions, if you're pricing things correctly, if you're hiring the right people, if you should take that leap that you're thinking about taking, and what companies should you invest in, in marketing.
How do I know if this is actually working? How do I steward what God has entrusted to me? I also know how powerful it is. To do that with a community. So over the next few weeks on the podcast, you're gonna hear me talking about the Wise Practice membership community. It is my passion. I love it. It's one of my favorite things that I do every week is meeting with you guys online.
So we are gonna be having the doors open again, March 25th through 27th, here at the end of the month, a three day window to join. After that, we will be closing the doors. After the 27th and we won't open them again for several months. So I want to make sure that you know about the community and what we do.
So inside of the community, for only $89 a month, y'all, that's less than a client session, one client session a month, you are gonna get live business trainings, real implementation support, accountability groups, courses you could take on your own, paperwork you can use for your practice, and discounts for resources you probably are already using.
So if you're listening. Think about joining the Wise Practice community, and you're gonna hear Jeremy's story today. And if you're thinking, I want that kind of momentum in my practice, pay attention over the next few weeks in these episodes as I interview different members of the community. And you hear about the amazing work they're doing, and I love sharing stories with you from other people because I know it can relate to you and where you're at.
And we can all gain from each other's stories. So we're gonna be sharing those here. I will be hosting a live webinar later in the month, so stay tuned for more information about that and to give you a clear picture of what it's like within our community. You do not have to do it alone, so if you're interested, head to the link in the show notes to learn more about the membership community.
But until then, we're gonna dive into this conversation with Jeremy Hinote.
All right, today on the podcast I've got my friend Jeremy Hinote. He's the owner and clinical director of Savannah River Counseling in Augusta, Georgia. He's a licensed professional counselor, national certified counselor, and a certified professional counselor supervisor in the state of Georgia. He works with individuals, ages 11 and up couples families, and treats a variety of concerns.
He has gotten level three trained as well as many other trainings here, and he's. Full-time as well. And he served in ministry for over 20 years, including roles in youth and family ministry and involvement minister. And he offers Christian counseling upon requests. Licensed in Georgia and South Carolina in a telehealth provider in Florida.
Husband, father of two, enjoys fitness, sports, outdoors, and active involvement in his church community. Thanks for coming on the show, Jeremy.
[00:06:14] Jeremy Hinote, LPC, NCC, CPCS: Thanks for having me. I'm excited.
[00:06:15] Whitney Owens: Yeah. Yeah. Well, let's uh, start with how we met actually. 'cause I'm a big fan of conferences.
[00:06:23] Jeremy Hinote, LPC, NCC, CPCS: Yeah. I was. We met at the LPCA conference in Atlanta.
I think it was, I think two years ago now. May it could have been longer. Yeah.
[00:06:33] Jingle: Mm-hmm.
[00:06:34] Jeremy Hinote, LPC, NCC, CPCS: And, um, someone, I think a mutual friend
[00:06:37] Jingle: mm-hmm.
[00:06:38] Jeremy Hinote, LPC, NCC, CPCS: That introduced us. 'cause I was at a place. Being at a, a large kind of corporate practice here in Augusta and was kind of at a crossroads of trying to figure out what to do, whether to, to stay there or kind of go on my own and friend of ours introduced us and was like, Hey, I got someone you need to meet and uh, I think took me to your table.
And then basically, I think I signed up at the conference to join the, um, the wise consulting community and, and then joined the mastermind group. Yeah.
[00:07:08] Whitney Owens: Yeah,
[00:07:08] Jeremy Hinote, LPC, NCC, CPCS: it was good.
[00:07:08] Whitney Owens: Great. Yeah. What made you decide at that moment to sign up? Because it's, you know, a lot of people, they wait, they're not sure.
[00:07:18] Jeremy Hinote, LPC, NCC, CPCS: Yeah. For me, I, I was definitely primed.
I'd already been thinking about. Going on my own. But then I realized, you know, I've never done this before and had no clue. Uh, even though I've, I've been on like the leadership end of counseling in practices, um, I still haven't done all those type of things. So, but talking to you and David Sturgis at the table, uh, and I kept kind of circling back to the table and asking questions, and y'all are willing to.
To answer questions I had. And uh, so I was like, okay, they, they sound like they know what they're talking about. Uh, there's a whole community of people that I could be bouncing things off of and really helping me. And so really through that, you know, knowing the, the, how big the community is and how many people are a part of it all over the nation, uh, that it's Christian practice owners, which was, uh, the ballpark I was in.
Um, and wanting that to be the, a big push for the practice. And then knowing things were organized and knowing there was trainings and. Webinars and knowing that there's other people in the same boat I am, that I could bounce things off of. All that together really helped me to make a decision to go ahead and sign up.
And, uh, and I've done, I'm on my third mastermind group now, so I just, yeah. Glad for punishment.
[00:08:33] Whitney Owens: Well, I'm, I'm so glad you did. And so, let's see, and that was May, 2024. So not even quite two years ago you were working at a group practice. And now we're recording this in February 20, 25, 6, 6. Mm-hmm. So not even two years.
And what's your practice like now?
[00:08:52] Jeremy Hinote, LPC, NCC, CPCS: Yeah. I went from the fall of 24, going out on my own, wanting to grow into a group practice. Um, hired my, an office manager and two therapists. In, uh, August of 2025, they came on. And so, so less than a year I added people and then kept doing the mastermind groups for kind of each phase of it.
And then, um, and then now I just signed a lease, uh, really like two weeks ago.
[00:09:21] Jingle: Oh.
[00:09:21] Jeremy Hinote, LPC, NCC, CPCS: Uh, or maybe last week for an o office that has eight offices. Um, and is more than double the square footage I'm in now and been already interviewing people and we've signed up an intern that's coming on. So, so yeah, we're growing and, uh, it's been exciting, scary, and exciting all at the same time.
So, uh, all in less than two years. Yeah.
[00:09:42] Whitney Owens: That's right. Love it. Love it. Um, I know we could talk about all that the whole time, um, but when we were in our group not too long ago, you talked about the success you had had in working with an insurance company that, you know, wasn't wanting to raise the rate and you were needing rates raised.
And I just thought it was such an important story to share with practice owners. I invited you to come on the podcast to talk about it. So let's kinda walk through that journey. 'cause I think a lot of people can relate. To insurance not reimbursing enough. Should I drop this panel? I don't know what to do.
So can you kind of take us back to how did you know that you needed to reach out and try to get rates changed?
[00:10:20] Jeremy Hinote, LPC, NCC, CPCS: Yeah. You know, I, I think, I think most people go into, especially insurance-based practices and especially, you know, people who are new to it, really not knowing that you can even do that. You know, I think there's a, a majority of people that don't even realize you can actually go to the insurance.
Panel that you're, uh, you're signed on with and contracted with and asked for raises along the way. So I started doing some research just even here, just locally. I started talking to other therapists and friends that took some of the similar insurances that I did. Uh, in this case it was, I was looking at tricare.
So number one, I realized. They were, at the time, they were my lowest reimbursement. Um, and we're in a military community, so we have a lot of, uh, military and military families, and that's something I've always wanted. I've, I've always done, but also wanted to continue to do. As we go forward, but the, the rate was really low and I had already been in it close to a year at that point and didn't know much about the contracts end of things at that point early on and realized, you know, I what I, what I signed, I signed when, because I was just trying to quickly get on panel 'cause I was now on own because I wanted to capture all those, those patients I had from the other place.
And, um, I knew they could leave and go somewhere else. So, um, so signed that contract, uh, knowingly signed that, uh, there was a percentage of a certain other number and it was very cryptic and you to have to decipher all that. But realized after, after the fact that what I had signed was to take a percentage of this other amount that was really low and actually was my lowest reimbursement.
So number one was finding my lowest reimbursement. Looking around at other people who. For example, a friend of mine who is, who is not fully credentialed with Tricare, uh, is not fully in network, and her reimbursement is higher than mine. She's just a few miles from me. So I started checking into that, realizing it was very low.
Really that is what I started looking at, even across the board with the other insurances. Just looking out there and, you know, 'cause a lot of people are gonna advertise it on their website and, uh, there's other places you can kinda look, uh, even Psychology Today or um, or just word of mouth. And I realize, okay, I need to start looking into this and see what I need to do to, to correct this and see if I can get it higher along the way.
[00:12:42] Whitney Owens: Yeah. Well, I think your story's super relatable. People who are on panels, they leave a group practice, they wanna start their own, they wanna get on panels as fast as they can to serve their clients. Mm-hmm. Um, so curious, looking back, do you wish that you had hired somebody to do the credentialing for you?
Or are you still glad that you did it yourself?
[00:13:02] Jeremy Hinote, LPC, NCC, CPCS: So, I, looking back, it probably would've been better if I would've hired someone to do the credentialing. Even though there was a part of me, I was like, well, I wanna do this myself. 'cause I'm doing everything myself, so I want to know the ins and outs.
Sure.
[00:13:17] Jeremy Hinote, LPC, NCC, CPCS: And so, and I did, I, I needed to know the ins and outs as a practice owner and, and then growing into a, a group practice. I did want to know some more of the back end of things, but, but that was one thing. Um, when I brought on people here, I did hire someone to do the credentialing after that. So with myself, I didn't, 'cause I was kind of, felt like I was in a hurry.
Yeah. To giving them, and that would've probably helped me to be able to ask someone to look at the contract to make sure that everything in there is what I think it is. 'cause now looking back, I realize, yeah, it's, it wasn't that. And there's things I needed to understand and know. And, uh, so yeah, so since that experience, I've definitely started doing some research into companies and groups and people that I can, I can call on.
And, and that's when I decided on this, the next round. And as we go forward, uh, I'll. I'll just pay someone
[00:14:12] Whitney Owens: to do that. Yeah.
[00:14:13] Jeremy Hinote, LPC, NCC, CPCS: Yes.
[00:14:14] Whitney Owens: Right. That's right. And, and hopefully they will negotiate for you and then you don't have to do that. But I love what you said that you wanted to learn the ins and outs yourself.
[00:14:23] Jeremy Hinote, LPC, NCC, CPCS: Mm-hmm. You
[00:14:24] Whitney Owens: know, I think there's certainly something to be said for that. And as you grow your group practice, you'll look back and you'll be like, oh yeah, I, I did do that even though someone else does it for me now I get it.
[00:14:34] Jeremy Hinote, LPC, NCC, CPCS: Yeah. Yeah. And I, and also it allow, you know, I have an office manager and so she and I have talked about.
'cause she's wanting to know that end of things. So that may be something we
[00:14:43] Whitney Owens: Oh yeah.
[00:14:44] Jeremy Hinote, LPC, NCC, CPCS: We kind, we kind of figure out together is as, as we go forward is, you know, running her through maybe some, some trainings and things of that nature. Uh, 'cause there's some groups out there that do trainings in, in insurance-based practices and helping you understand the ins and outs and what to do and how to write, you know, the template of a letter to the insurance companies and how to actually ask for.
A higher rate bef during the crediting process and before you sign the paperwork, because that's, you can do that as well. Doesn't mean they're gonna necessarily give you what you're asking for, but you can ask for that even before you sign and see if you can get it higher.
[00:15:20] Whitney Owens: Yeah. So when you realized how low your rate was that you needed to make a change, were you the only one taking that insurance in your group practice?
[00:15:28] Jeremy Hinote, LPC, NCC, CPCS: I was. And I, I was actually shocked in the end all what took place. Uh, 'cause at the time I was the only one. I mean, it was just me. Here, and I had been credentialed the other insurance companies through a different means, and then, but wanted to make sure I did tricare. So then I started that process. So I, you know, I called the insurance company and, and started asking them questions about, Hey, what do I need to do to, you know, I'm wanting to ask for and negotiate a higher rate of, uh, reimbursement.
And so generally, like with Tricare. You would go through your area representative. My area representative wasn't very helpful, so that didn't help me at all. And so I went around her and, uh, found out who I needed to send information for about Rene Renegotiation. And there's, uh, like with Tricare, there's an email, uh, that they will give you to send everything to, and there's a group that just handles all that.
And so. You know, once I got that information, I found out, at least with Tricare, and this is where all the insurance companies are different, Tricare, whenever you sign up. So I signed up in OC October of 24. You each year at your anniversary, you have 90 days before your anniversary to renegotiate if you're gonna renegotiate.
So I started in July of this past year, putting everything together and so I can send it off to that email. Address. And so, you know, I put a letter together with all different kinds of information and, um, that was, uh, you know, kind of sharing what I do and who I am and my credentials and how long I've been practicing, and, uh, the things that I do that are maybe different than other people.
And kind of going down this list of things and my caseload. Um, and a number of, of kind of bullet items that I put on there. And then I actually did something that typically you don't do with insurance companies, which is, is tell them the percentage you're looking for. Uh, sometimes you're just asking for a higher rate, but sometimes you can, you can actually say, well, hey, I, this is kind of what I need.
'cause a lot of the insurance individuals that, that train you in how to ask for raises. Usually we'll tell you, you know, it's probably not a good idea to make an ultimatum. It's probably not a good idea to say, Hey, if you don't gimme this, I'm not, this is what's gonna happen. The, the, the crazy thing is I kind of did that and I said it very nicely.
I used AI to help me formulate a really good letter with all my information and, um, and, you know, had a, I let them know how low they were compared to all the rest of. The insurances I currently have, and they're the lowest by far. And so I wasn't even asking them to go beyond what my highest was. I was really just wanting 'em to fall in the middle somewhere.
And so I started that process. I sent the first email, uh, and typically it's like a four to six week week window that you're going to be kind of communicating back and forth. If you go back and you don't agree with their terms, then it could last longer. So I started in July. And it went into September, um, before I was getting closer and closer to my date, uh, before I finally, we agreed to terms.
So I gave them the whole spiel. They kicked back an email and you know, just basically saying, well, a lot of niceties, we can't go as high as you want, but we'll give you this. And it was maybe like 2% over what I was making before 'cause it's a percentage of a another number. And so it was only gonna raise my, like, my reimbursement per session, like $2.
So I push back and, you know, just kind of send back another very nice communication with them, you know, explaining more information to them again and just letting 'em know, hey, I, I can't accept that I need it to be this amount, you know, this percentage. Um, waited another week or so. Got communication back.
They took it up about four more percent, so now I'm up to like 6% more. Still was not where I wanted to be. Communicated back with 'em again. They communicated back with me again. They went up a little bit more, and then I think it was the fourth time was a charm, so I finally. I finally just told them very nicely, like, I, I, you know, I really, I really honor our military and their families, and kind of went to this field.
Like, I, I, you know, I'm, I'm, you know, I'm running a, a private practice, you know, I, I, I just simply can't afford and running a business to, to take this rate, accept this rate. I have to have it at this certain amount. To be able to basic, basically continue be on, be on panel, uh, with you guys.
[00:20:16] Jingle: Yeah.
[00:20:16] Jeremy Hinote, LPC, NCC, CPCS: And so finally the fourth time, they sent back a percentage that now was not my lowest and in fact kind of fell in the middle.
And it was a, definitely a rate. I think I probably, money wise, it went up about $20 a session. And so Wow. That was a huge race. So,
[00:20:33] Whitney Owens: yeah.
[00:20:34] Jeremy Hinote, LPC, NCC, CPCS: Um, so I finally, when they got there, I thanked them and we, uh, everything was good to go. You know, everything has been, has been good since. And then, and then, and then once I got myself in that position, because I'm, I'm credentialed under the business tax id, when I brought on another LPC, I was able to bring them in under that same, so they actually get paid the same as the practice does.
So instead of them starting off a real low amount, they actually make what I do, which is great. So it's been, it's been really good. So we're enjoying Tricare and you know, as much as you can. Enjoy government insurance and the ins and outs and sometimes the frustration. So
[00:21:13] Whitney Owens: yeah. That's great. I love that you included in there your passion for caring for these families, you know?
That's why we do the work we do.
[00:21:22] Jeremy Hinote, LPC, NCC, CPCS: Yeah.
[00:21:22] Whitney Owens: I'm curious how stressful this must have been for you. Was it really difficult to kind of manage all that while you're running your practice? And I'm guessing there were times you wanted to give up.
[00:21:32] Jeremy Hinote, LPC, NCC, CPCS: It was. Yeah. 'cause I, I was, you know, at first I was really discouraged when I first got back that first email.
And at that point I was just like, you know, what do I have to lose? You know, I mean, so I did have, I had to change my own thinking about it. I had to get to a place of my own thinking that, where I was like, okay, I have to be okay not being on panel with them. Like, I have to go all the way there in my thinking for me to be able to take these steps.
And that's, that's basically where I was able to get to. I, I didn't want to do that 'cause I. I honor, I mean, I really care for the, these military families. I, I respect what they do and, and for our country and I, I didn't wanna not see them, but I had to make up my mind to say, you know, Jeremy, you gotta be okay not being on panel with 'em anymore.
And so then when I didn't feel like I had anything to lose is when I, it made more easy for me to send the replies and keep pushing gently and kindly. I wasn't trying to be mean to them or anything like that. It was very. Thankful and appreciative and you know, everything, every step of the way, hopefully to just minimally to grease the wheel some, uh, if I, if I needed to.
So, but I did, I mean I, I went through a lot of that 'cause I did, I've seen it in military and we're in a military community and it's the last thing I wanted to do. Uh, so I had to make plans for figuring out how to do a cash rate for those individuals and, you know, maybe even not see 'em if they didn't, they want his user insurance.
So, um, but what
[00:22:52] Whitney Owens: percentage of your caseload would you say was Tricare?
[00:22:56] Jeremy Hinote, LPC, NCC, CPCS: Um, at that time I probably had 30 active patients or families. So at that time it, it was 40 to 50%. I had a lot, you know, that I was seeing weekly, uh, of my caseload. So, um, and I, I think that helped in my argument. Because I was seeing such a large, and I kept, I was, and I kept receiving faxes.
Referrals. Uh, I, 'cause I finally got to the point, I had so many, I couldn't see anybody else.
[00:23:25] Whitney Owens: Yeah.
[00:23:26] Jeremy Hinote, LPC, NCC, CPCS: So they kept sending. So,
[00:23:28] Whitney Owens: so did you keep taking track your patients while you were negotiating?
[00:23:32] Jeremy Hinote, LPC, NCC, CPCS: Uh, I did. I kept doing that just in case. Um, not knowing exactly what was gonna take place, but I was, I was glad prayerfully.
I was happy that it all worked out in the end. Mm-hmm.
[00:23:45] Whitney Owens: Yeah. Another, I think, important point here is this balance we have as therapists that we want to care for people, but we have to run our business. Yeah. And that so much of the work that, that I see, that I have to do with practice centers is getting you to a place of like, yes, it is about the clinical work, but if your business doesn't succeed.
Then you're not doing it at all. Right? And so I love that you, you saw, Hey, I've gotta pay attention to this business. I can't suffer because of this. And I, and it's not right that you should have to, even when I'm working with practice owners, with insurance-based practices, it's, Hey, let's look at all the ones, what are they all paying out?
And you're right, there's some of them that are paying out 20, $30 less than other ones. And I'll always be like, why are you on that panel? Get off of it. Because it is, it's strictly a business move.
[00:24:35] Jeremy Hinote, LPC, NCC, CPCS: Yeah, it is, and it's like, like with me, I have a, an LAPC that works with me and with, if you're associate level, you can, with insurance, you, there's two insurance companies generally you can do supervisory billing.
So I, she gets billed underneath me and that's Aetna and Cigna. Or any like, subsidiaries of them, like, uh, Meritain Health is
[00:24:57] Jingle: Yeah.
[00:24:57] Jeremy Hinote, LPC, NCC, CPCS: Is connected to, to Aetna. And so, but Cigna, for example, is by far my lowest. And, but I'm kind of stuck actually. They're, they're the, they're my next, they're my next one that I'm gonna be doing this same process to.
'cause theirs is horribly low. And so, but I, I use them, I need them in a sense because. They're one of the ones I can do supervisory billing and us being mainly insurance based. Um, it allows me to give her patients as people are calling to wanna use Cigna. Um, so, you know, but, uh, but I've been with 'em long enough credential my own and we have enough of volume.
'cause you sometimes you need time with that insurance company that's, you know, right now we're in the kind of a phase of the headways and ALS of the world that you're using to be credentialed through. And a lot of the, and it's been, they handle everything for you, credentialing, billing, everything. But at the same time, if you want to get higher rates, sometimes you do need to be credentialed on your own tax id, but you need to use that insurance a good bit to get to gain some clout with the insurance company.
So, uh, so that you can go to them. So like, if I'm credentialed with Cigna, but I'm never using them 'cause I'm using them through headway, well that doesn't help my, my cause to, to approach them and ask for a higher rate 'cause I'm not using 'em. So if they see I'm using 'em, which I am, 'cause um, my, my LA PCs are using them, well then that gives me more clout and we can be seen as a practice better with all the different specialties and things that we add to them.
So then I have a little more push to ask for a higher rate at that point.
[00:26:35] Whitney Owens: Yeah. How much time would you suggest working with an insurance company before asking for raises?
[00:26:40] Jeremy Hinote, LPC, NCC, CPCS: Most of the time you, you want to be with 'em close to a year. You know, the different companies like Tricare, they want you doing in 90 days before you're, when you sign with them, the other company, sometimes you can ask for raises every six months.
Usually. I mean, the, the default is, is probably once a year. You can ask, uh, it doesn't mean you'll get it, but you need to ask. Mm-hmm. Uh, meaning when you ask them, you put on your calendar so that you know next year to ask at the same time. Um, and just don't take no for an answer at that point. But I would say you probably want to be on there about a year and, and it actively using the insurance under your tax ID for that long.
So you have a little more push with them because they, you have proven you're gonna use them and you're seeing their patients and you're helping their, their clients along the way.
[00:27:31] Whitney Owens: Yeah. Were there any resources that you wanna recommend or mention that helped you through this process?
[00:27:39] Jeremy Hinote, LPC, NCC, CPCS: Yeah, there's, uh, so there's a lady, her name is Barbara Griswold.
She does the insurance maze, uh, and that's actually her website. It's like the insurance maze.com, and she has a book, it's called Navigating the Insurance Maze. It says it's the therapist complete guide to working with insurance. And also whether you should or not. So, and she's actually an LMFT, I believe, but is kind of an expert in a sense, into the insurance realm as well.
The, uh, for me, my, my wife has helped me as well. She works for a mental health company and that's, that's the side of things that she's on. So she has been nice being able to ask her questions along the way. The insurance maze. Website also has a template, which is very helpful. So if you're looking for a template to, 'cause you really need something, the template is more bullet pointed.
And so, and really the letter you're writing is like, this is your plea. So you, you want to be able to ask, call the insurance company first and kinda. Ask, you know, Hey, where, where would I send this communication? But before you do that, you really need to have your letter complete. Like you need to have your requests and all your information done, because there are times where while you're on the phone with them, they may want to go ahead and say, well, hey, tell me, you know, tell me about, tell me about this.
And they wanna hear your pitch on over the phone. They usually won't do that, but you have to be ready for that. And so, but basically you're, you're setting up your argument. I mean, you kind of have your bullet points and, and everything. And in, in, in that, the biggest thing you're trying to do when you're, when you're asking for any kinda raise is.
You know, you're kind of asking yourself, well, what makes me stand out? Is it the fact that I see 50 of their patients or clients every week? Or do I have a special training? So, and there's a number of things you can kind of look at. You know, like if, are you bilingual? Are you multilingual? Um, do you, do you have specialties?
You know, they are not as interested about you telling them that you do anxiety depression, because every single person that. A licensed therapist should be able to do anxiety, depression. You can put that, but that's not what they care about. You know, they want to know, you know what, what makes this person worth it?
Do you, A couple of big ones are addictions. Sure. Chemical addiction, sexual addiction, eating disorders. Those are biggie if you do it, those are gonna make you kind of stand out. Do you have licensure in other states? Um, 'cause that means you can use that to say, Hey, I have licensure in other states. So I can meet more the needs of your clients that have your insurance.
They want to know more about evidence-based treatments, which, you know, is what we should be doing, especially if it's brief. 'cause they like that because they don't have to pay you too much. So, so if it's, it is focused on symptoms, uh, you can, if you're have a specialty in CBT or DBT or E-M-D-R-A-B-A.
Anything, trauma informed, mindfulness based kind of stress, reduce re uh, reduction type stuff. Yeah. Um, also like if you do any kind of critical incident type. Trainings like, um, debriefing or like employee wellness workshops and things like that, that's a biggie. They also want to know that you are tracking the symptoms and the progress.
So throwing in there that you use a PHQ nine and a GAD seven or, or other kind of symptom tools. Um, but also do you see social populations, uh, especially if, if they're underserved in your area. So like for me with Tricare, it's a big deal because we live in a military community. So do you see veterans, do you see L-B-G-T-Q?
Do you see child and teens, adolescents, because that's, those are, those can be biggies. Uh, if you do, uh, do you work with autism and A DHD, especially with kids, do you work with kids and adolescents that cut or have si. Those are all biggies that if you do and you work with those, but also look for diversity.
You know, if you do enough research and you go online and you look at who is in their, in their bubble of clinicians, if you research hard enough, you can kind of find out, okay, who's on panel with them and what specialties do they have? And then this is like the deeper research. Like, so you need, you have to spend some time doing this, but this is to prove your case.
So if you find 10 clinicians and you know, let's, you know, so let's say they don't meet a certain demographic, uh, or they don't advertise that they see certain groups of people, then, and that's something you do, then that's gonna heighten you above the rest of them. And so, um, those are key things Also, if you used to work somewhere, so let's say you did your internship at a, a mental health hospital or an IOP or some kind of critical response team, you want to include that in there.
Now you may not want those referrals all the time. That may not be the demographic you're look really looking to work with, but that boost you in some way that highlights. So highlight even old experiences that you have been trained under and and have been used to because that's gonna also help you. As well.
So those are, I mean, those are all things, that's a whole bunch of different stuff, but that's the stuff you want to include on that bullet point letter. You know, letting them know that also your caseload, maybe you're a high volume of X, Y, and Z, or maybe also you wanna include, Hey, I haven't had a raise in this this amount of time.
You want to include that too. Some people, they've been on panel for 10 years and never asked for a raise, or never got a raise, and you wanna include stuff like that in there along the way as well.
[00:33:12] Whitney Owens: That's great. Wow. This is super helpful. You, you certainly have learned the ways. I'm
[00:33:18] Jeremy Hinote, LPC, NCC, CPCS: still still learning.
[00:33:20] Whitney Owens: Yeah. Is there anything that we didn't discuss that you wanna make sure to mention?
[00:33:24] Jeremy Hinote, LPC, NCC, CPCS: Yeah, I think most clinicians, especially if you're insurance based, I think the thing we, we try to avoid is being on too many panels. I think initially we think that's gonna be very helpful, but like from the running business side of things.
And having good reimbursement. I do think it's important that we, we have some of the main insurance companies that are in our community. Uh, that's one of the first things I was trying to be aware of is like, you know, what are, what are like the bus big businesses around me? You know, what, what's their insurance?
You know? And yeah, sometimes that's not easy to find. Like I, I make contact the county here or local county to find out, okay, what are, what's the insurance that are the county workers are using, or the school system or one of these big companies. They usually go with some of the larger, you know, companies like Blue Cross Anthem, you know, Aetna, Cigna, uh, United Optum, you know, and then you got Tricare Medicare.
But I would say like, you know, narrow it down usually for the business end of things. You know, there's a lot of insurances that don't pay very much or mers, and the trap you could get into is if you allow for too many of those low paying reimbursing insurance companies. Well now. All the people coming to your practice may only take those or only use those, and that may put you in a financial burden.
And so you do, you kind of have to tease out, you know, how many am I gonna take? Am I gonna take four highest or four of the main ones, or five or six? You know? So I would, I would, I would encourage people to kind of narrow down,
[00:34:53] Whitney Owens: yeah,
[00:34:53] Jeremy Hinote, LPC, NCC, CPCS: insurance companies are gonna use, you do need, uh, to run a business. So you do need them to reimburse you at a certain level.
So you need to do the math to find out. What if every person that shows up comes in as a Cigna patient? I gotta be prepared for that, or I gotta prepare a boundary around that. One of the two along the way as I enter into this, but do your research. Look around, ask friends in your, in your community.
What's their reimbursement? Most of 'em, they're, they'll be honest with you. It kind of gives you an idea of kind of where you're at. Uh, if you're too low, then that may be the time to really either hire someone or use a template and or someone else that knows and has done this before and ask 'em, uh, how you can kind of formulate a good letter that's fits you well and gets you where you need to go.
[00:35:38] Whitney Owens: Yeah. It's great. Well thank you for all of this Good advice. Um, this is gonna be super helpful. Um, as we're kind of closing up, I wanted to ask you about the wise practice membership community. Yeah. Uh, we talked about it a little bit when we got started, but could you kind of share why it's helpful to you and honestly, has it been financially worth it?
'cause I think a lot of therapists, we struggle to put that financial commitment into something.
[00:36:03] Jeremy Hinote, LPC, NCC, CPCS: Yeah. You know, initially with a membership, you know, that was the first thing I signed up for, and I've, I've encouraged other people, even in my area here, that I knew were about to go out on their own. And I told them, I said, I said, minimally, sign up for the membership.
You know, it's X amount of dollars a month. I was like, it's, I said, there's so many resources on there. There's, there's meetings every single week, almost every day of the week that you can bounce into from, you know, you're just starting off and trying to figure out what to do to. Um, going into a small group practice and there's in, in every step and phase of the practice, um, there's, there's a group for that.
There's other people that are all around the country going through the same thing that you can bounce stuff off of. So that was a huge value. That was the first thing I did. And there's the website, the, the circle has an immense amount of documentation and really everything you need to start a practice.
So even if you just become a person in the community, you're gonna have all the resources you need and more. On the website just to be able to go off of, you know, and then if you jump into the different, uh, meetings and groups that are there constantly and you, you're active, then you're gonna be able to get all the information you need more.
So that's been a huge value. And then through that I learned about the mastermind groups, um, which are the more specialized groups that are very small and are there with a coach that's working with you every other week for six months or longer. And there's one for every phase of where you're at. And that's kind of what I've done.
You know, I went from being on my own, so in a solo practice to joining the next mastermind group that was starting a group practice. And now I'm in the one with Whitney, uh, that is growing your group practice. 'cause that's the phase I'm I'm in now. And so, uh, but it's been great. I've told people that. It was worth every penny because it's kept me in check and accountable and I, and I feel like I'm, I'm confident in knowing that I'm going down the right path.
[00:38:01] Whitney Owens: Mm-hmm.
[00:38:01] Jeremy Hinote, LPC, NCC, CPCS: And being, and keying in on all of the, the things I need to know about that as all of us were not trained in our masters or doctorate or whatever to do. They didn't train us on any of that stuff. So this is basically that, like this is gonna train you how to do everything. Um, and more and give you all the people around you to do that.
So I would highly recommend to sign up for the community, but also mastermind group for sure.
[00:38:26] Whitney Owens: Yeah. Well, Jeremy, thank you for all your kind words and your commitment to Wise practice. And I was just talking to somebody the other day about it's those that show up, do the work, their practices grow, you know, and you certainly are in that category and have shared that with us today.
So thank you for that and uh, appreciate you taking the time to be with us today.
[00:38:46] Jeremy Hinote, LPC, NCC, CPCS: Absolutely. Thank you.
[00:38:51] 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.
[00:39:09] 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.
