In a previous article, I talked about some of the benefits of online platforms like Talkspace, Headway, Alma, Grow Therapy, and Rula, as well as some of my concerns about them and ethical dilemmas that are popping up (if you missed that article, click here). Since I posted that, I’ve received a FLOOD of mail, both from those sharing their bad experiences with these platforms, but also from those who wrote to share their positive experiences.

As I said: My goal with these articles is only to help therapists to think carefully and ask better questions before joining, to make sure that participation is right for them, and if so, to participate in a way that works for them with the least risk. Today’s article focuses on things to consider and to investigate before you join one of these platforms, and questions I recommend you ask before joining.

Before You Join

• Most importantly: Take your time when joining, and ask LOTS of questions first. This is a big financial decision.
• Start by thinking about what YOU need and want from a platform – and what you don’t want.
• Compare the different platforms available that bill insurance. These include Talkspace, Headway, Alma, Grow Therapy, Rula, Zencare, and Sondermind; Betterhelp does not bill insurance.
• Read every page of the platform’s website. Some important information is buried on inside pages of the website. Write out any questions that come up for you.
• When possible, talk to therapists who have joined the platform about their experiences.
• Ask for a sample contract. Read over the contract carefully before signing to see what you would be agreeing to, and to see if you have any questions.

Here are some of the questions I recommend that you ask:

1. Is there a monthly fee to work with your platform? If so, how much?
2. After a session, what steps must I take to get paid? How much will I be paid per session?
3. Do you pay me even if a client no-shows or late-cancels? Do you bill the client? If so, how much (should not be more than the insurance rate).
4. What states do you operate in? (But remember, to legally see a client who is located in another state at the time of a session, you need to be licensed or permitted to practice in that other state). Do you accept interstate compacts?
5. What insurance plans can you credential me with? Can I choose which plans to credential with? How long will it take to credential me?
6. Medicare: Either 1) Can the platform credential me with Medicare and bill Medicare? Or 2) do you accept therapists who have opted-out of Medicare?
7. How exactly am I paid? How long after the session will you pay me?
8. How are collections from clients handled?
9. What will you do if insurance does not pay as expected, and there is a balance on the client’s account?
10. Is assistance provided to me for billing for my private-pay clients, or only insurance clients?
11. Does your platform have a built-in client scheduling calendar? Is it my choice whether or not to use this calendar to schedule? Will I be able to screen clients before a first session?
12. Do you have a built-in progress notes program and treatment plan program? Must I keep my progress notes in your platform, or can I keep them in an external program?
13. In case of an insurance plan audit, will you always notify me before releasing records?
14. Do you have access to my client charts? Might you do internal audits of my charts?
15. Do you offer clawback protection for providers? (if so, please tell me more.)
16. Do you have a secure patient portal?
17. Do you have a built-in telehealth platform? Must I use it?
18. Is there a minimum number of hours I am required to work each week?
19. Do you send appointment reminders?
20. Do you give therapists a Business Associate Agreement (BAA) agreement? (This is necessary to be HIPAA-compliant.)
21. What kind of support do you offer to providers (email, text, phone)? If I have a complex question, do you provide phone support?
22. If I choose to discontinue working with your platform, what are the steps I would take, and how much notice would I need to give?
23. Would I have access to my notes after leaving your platform? If not, is there a way to download my notes before leaving?
24. Will your platform help me market and build my practice? If so, how?
25. Does your platform offer an online community of therapists I can interact with?

Remember: if you join, you are responsible for knowing and following the laws and licensing rules of any state where your clients are located. These platforms will not always be aware of these. You are also responsible for making sure the claims and codes submitted by the platform are accurate.

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