OT Private Pay Practice: How To Answer The MOST Dreaded Question

Video Poster Image

Even seasoned occupational therapy private practice owners get nervous answering the dreaded question "Do you take insurance." But, crafting your own confident response to this frequent question will make all the difference


LINKS: some of these are affiliate links which pays me a small portion at no extra cost to you. I only recommend things we personally use:

👉The powerhouse website builder we use to support our clients

👉Book recommendation

Fo Occupational Therapists who are starting or even already have their own private pay practice, the insurance question will come up again and again. But, rather than fearing this question, let's flip the script and become confident when answering this question. 

In this video, Doug Vestal, Ph.D., discusses a tried and true method for occupational therapists in private pay practices to confidently answer this question, build a rapport with a prospective client and how to attract clients who will gladly pay out of pocket.

This video is not intended as professional or legal advice. Be sure to seek the services of a professional and understand the risks you are undertaking.

Transcript of Video:

There is a pit in the stomach of most occupational therapists in private pay practice when they get on the phone with a prospective client and the client asks “Do you accept insurance?”


You can almost hear the nails on the chalkboard.  The record scratches and comes to a stop.


But, how you answer this question can be all the difference between you booking the client right then and there or you stumbling through it awkwardly and the client saying “okay, will let me do some investigation and I’ll call you back” only to never hear from them again.


So I’m going to show you how to confidently answer this question in this video.


But – stick around until the end because I’m going to share with you the number 1 thing you need to do ahead of time in your private pay practice, before this conversation even takes place, so that you are attracting clients who gladly will pay out of pocket – thereby making this question almost irrelevant.


I’m Doug Vestal and I help OTs just like you start and grow thriving private pay practices.  And I make these videos based on what we’ve learned owning our own OT private pay practice so that you can have the success you want faster.


Look, I totally get it, having the conversation about whether or not you accept insurance is perhaps one of the most nerve-racking conversations you will have with your client.


It is right up there with telling them your price.


I mean, for most occupational therapists, these 2 conversations are so fraught with emotion that you can feel a cold sweat start to form just thinking about it.


You start to stammer, you start to studder, and in the back of your mind you have this big fear of rejection from the client that is weighing on you the whole time.


And what ends up happening?  You end up over-explaining.  You end up sounding nervous.  Your voice starts squeaking. 


Or suddenly, you start to get awfully serious and you don’t know how to keep the rapport going with your client when you start talking about the quote/unquote “business stuff”


But here’s the problem, this lack of confidence shines through to your potential client.  If you don’t sound confident in addressing this question, then the client is going to start to doubt your ability to help them.  They can sense that something is off.


So, you want to get super confident in how you answer this question.  And the first step in getting super confident is to really create a script for yourself ahead of time on how to answer this question.

And, you want to practice this script, and all its variations ahead of time.  Practicing what you are going to say, how you will answer the follow up questions, its critical to getting the confidence but also really dialing in what you are going to say to make sure it’s the most impactful.


So – let’s talk about 2 scenarios and the ways in which you can respond.


The first scenario is the following:  someone calls and immediately asks “do you accept insurance.”


In this case, you want to resist your urge to answer the question immediately.  You haven’t even established a relationship with them yet.  You don’t even know if what they are dealing with is something you can help with.

So – from a clinical perspective, put the insurance question at the end of the line.  Your clinical skills, your ability to help the person, which is what you are there for, have nothing to do with insurance. 

So, instead, what you can say is something like the following:

“Well look, how we work with our patients/clients, is totally different than what you’ve probably experienced before.  We offer a very unique service that’s very tailored.  But before we get into that, I want to make sure that what you have going on is something our practice can help you with.  So, what are you dealing with right now?”

Or something similar to your OT specialty.

The point is that you want to get them talking about their problem, why they are seeking your OT services.

Getting them to open up about their problem is important for 2 reasons. 

Number 1: you want to make sure they are actually a good fit for your practice.  That this is something you are actually qualified to help them with.  Otherwise, you know, you can refer them to someone else.

Number 2: Once you know that this is something you can help them with, then you can start to build a relationship with them.  Talk to them about how what they are dealing with is something that your practice specializes in.  Talk to them about how you’ve had similar clients who had similar problems that you’ve helped with in the past.  You want to build up confidence that your practice is the one for them.

And then, and only then, bring the conversation back to insurance.   Ask them what insurance they have.  Let’s say it is Aetna.

What you can do is say something like this:

“I’ve worked with a lot of clients like you who have Aetna. I do charge upfront for my services, but I provide you with a receipt at the end of each of our sessions that you can submit to Aetna for reimbursement according to your out of network insurance plan benefits.”


And you have to practice saying this confidently.  Saying it with pose.  Practice saying it in the mirror.  Practice having a friend role playing the scenario with you and you responding.


With practice you will get a lot more confident.


The second scenario is more a follow-up.  Let’s say you’ve already established the rapport with the client.

Let’s say you’ve already given the previously prepared, very brief, speech.

Sometimes, that brief speech is enough.  The client may already be familiar with paying out of pocket and submitting receipts.

But, other clients are going to have more questions.  Maybe questions on logistics or more of a question of “well, why can’t I just pay you my co-pay and you file with my insurance?”


And in this case – it’s an opportunity to really draw a contrast between what you can do by not accepting insurance versus what they could get elsewhere.


Many clients don’t understand the difference.  So drawing the contrast is really important.  And putting the contrast in terms of their goals is super important.

So, you’ll have to adapt this to your specific specialty, but it would go something like this:

“The work I do is very custom and completely tailored to you.  I am taking an entire, holistic, look at you to get you back to doing the things that are meaningful in life.  And to do that, I’ve found that I need to spend a full hour with you.  I want to get you better as quickly as I can.  And from a clinical perspective, my dedication is to my patients.  Not the insurance company.  And since I am out of network, I get to do what I feel is clinically best.  A lot of my competitors do accept insurance, and because of this, they have to see 3 or 4 clients an hour while I get to spend an entire hour with you, completely undistracted.  I think that’s better for your progress and your goals.  And I give you a bill at the end to submit to your insurance company.”


Creating that contrast works really well.  You are demonstrating the care you have for their well-being by the choices you’ve made.


Okay, so those are some ways in which you can answer the “do you take insurance” question and feel very confident about it.


But – I want to talk about a step that a lot of people overlook that makes this conversation go a lot more smoothly.


And that step is how you are positioning yourself ahead of time. 


The insurance question really isn’t a big deal if, ahead of time, they are already convinced you are the right person to solve their problem.


In that case, if they are already convinced you are the OT for them, the insurance discussion and even the pricing discussion, becomes secondary.


Because they believe so powerfully that you are the one for them that they have convinced themselves they want to work with you no matter what.


You will get a lot of pushback on insurance if most of your calls coming in are what I call “cold.”

What I mean by “cold” is that they have a problem, were told they needed to see an OT and just call you up because they found your information on google.

For those people, insurance will be one of the first things they will ask and may be a screening criteria.


But, contrast that to someone who is warm.  Someone who is warm is maybe someone you met at a local community event you were a sponsor at, and you handed out a piece of free education.


And then, that person started watching educational videos you’ve posted on your specialty.  And from these educational videos they then attended a workshop you hosted.


By the time that person calls you, they already know, like and trust you.  You’ve already given them value on their problem before you’ve ever charged them anything.  You’ve already established yourself as an expert in their eyes.  You have a massive amount of credibility.


When that person calls you, they have pretty much already convinced themselves to book with you.    


Dealing with warm potential clients in your occupational therapy practice is incredibly different than dealing with cold potential clients.

Cold potential clients - you will feel like you have to convince them which isn’t going to feel good at all.

In contrast, warm potential clients won’t need much convincing at all.  They will have already convinced themselves.


And this all comes back to the OT practice marketing you are doing.