In this conversational segment, Kelly Alhooie addresses common concerns clinicians have about insurance reimbursement and operational workflow in cash‑based practices. She explains that there is no strict “plan‑of‑care police,” allowing flexibility in how clinicians handle documentation. Using her experience in Florida (a 30‑day rule requiring a prescription for insurance reimbursement) and Virginia (a 45‑day window before direct‑access became available), she outlines how to meet state requirements while keeping the process simple. Kelly shares her hybrid approach—balancing the needs of type‑A clinicians who want exact instructions with a more relaxed, risk‑tolerant style. She describes an automated email series that reminds patients of consistency, informs them of the 30‑day law, and prompts them to obtain a script from their primary care provider, thereby reducing manual admin work. The discussion concludes with the practical takeaway that clinicians do not need to fax the plan of care to physicians; instead, they can place the responsibility on patients, saving hours of work.
Chapters
I just didn't like how I felt like I, I didn't know what to say to those people who are like, well, why is this so expensive? I have insurance. I'm like, I, I don't know what to say to you. Okay. Faxing plan of care to physicians. Like, I, some of this stuff I was thinking like, oh, I'm just going to figure it out as I go. And next week I have 17 clients on my schedule and I'm like, all right, I need to, I need to do this like Tonight, tomorrow, get it going. So, um, do you have something that you rec— like a— and like, I— in Florida, it's like within 30 days.
Is that what the plan of care says? Um, all right. So this is what I do with plan of cares. Let me explain this. And, and there is no plan of care police. So it depends on how you want to operate. I operate in the very gray, loose area. I am not the type A-er. I have people in the program that are type A-ers that are like, Kelly, I need this 100%. I am not a type A-er and I will take the risk over than being type A. But I know that some people want type A, like they want instructions on that. So I'm going to give you both sides of the coin. Okay. So in Virginia, we had 45 days and then eventually we had direct access. So I have operated under 45 days. Okay. And what I used to do in Virginia was I— so we have email series going out to these people that have booked. Okay. Because the email series that I have set up basically say like, you can't quit. Consistency is key. Like reminding them why they're continuing. Because when they start feeling good, they want to drop off. Right? Right. In those email series, I've also set up like the third email in Okay, where you can put, by the way, and I just quickly put a blurb because then it makes me feel better. Hey, it's been 30 days. I want to let you know, or we have a 30-day law here in Florida that basically if you want to be reimbursed from your insurance, you will need a script. Please contact your primary care and they can send it over to this email. And that way, I think this is like the best happy balance I have found. You feel confident because you have alerted the patient, okay? And that makes you feel better. However, there is no script police. The only way— the only reason why you actually need a script is because the insurance company, if they're trying to get a super bill, then they're going to be like, "Oh, you don't have a script. We're not even reimbursing. We're not even talking to you." Okay. Other than that, there is no one literally going, you don't have a script today for this patient, you can't see them. There's no police, right? Okay. Yeah.
So I don't have to fax plan of care to doctor?
No, no.
I can put it in the patient's court to sit. I mean, that's going to save me like hours of work.
So trust me, because there's no way. It's so hard to keep up with it on a spreadsheet and then you have to hire an admin to like— no, no, no. Like you have so many other things you need to be doing. No. Okay.
