We were lucky to catch up with Samantha Silverman recently and have shared our conversation below.

Hi Samantha, thanks for joining us today. It’s easy to look at a business or industry as an outsider and assume it’s super profitable – but we’ve seen over and over again in our conversation with folks that most industries have factors that make profitability a challenge. What’s biggest challenge to profitability in your industry?

In my opinion, accepting Health Insurance is the biggest challenge to profitability in the mental health industry. I LOVE being able to accommodate our clients’ mental health needs and ensuring they can use their insurance benefits for counseling. However, health insurance is a convoluted, bureaucratic, and a heavily regulated maize. Mental health care workers are frequently scrutinized by recurring audits, low reimbursement, clawbacks or recoupment (insurances demanding funds be returned after paying for claims), and claims being denied for no decipherable reason. Due to these constraints, practice owners and providers are refusing to accept health insurance and turning to private pay practices. This is detrimental to the client, who oftentimes pays an exorbitant monthly premium for care.

Our clients rarely witness the behind the scenes work that goes into insurance billing. And unfortunately, insurance issues, billing, and follow up comprise at least half of the administrative work day. It is challenging to run a successful health practice whilst simultaneously placating health insurance companies.

As always, we appreciate you sharing your insights and we’ve got a few more questions for you, but before we get to all of that can you take a minute to introduce yourself and give our readers some of your back background and context?

I am most proud of our compassionate team of therapists. Although we do not share an office and are all home-based, our team is comprised of an incredible group of individuals who are all so dedicated to their clients.

Any advice for managing a team?

Fostering a positive team atmosphere is paramount to building a company culture. Your employees are your biggest assets and there needs to be a balance between giving them as much as possible and maintaining revenue and growth.

I also have learned how to ethically let employees go who are not. a good fit for our team or for the clients that we serve. Having a negative experience with an employee creates emotional angst. This is detrimental to proactively focusing on growing your business and trying to help as many people as possible. Negative emotional strain is time consuming, exhaustive, and should not occupy a leader’s mental capacity.

The owner or leader of the team is ultimately responsible for creating the company culture, attitude, and values of the entire group. As a leader, it is imperative to remain positive, communicative, and proactive.

HUMOR, GRATITUDE, and HUMILITY will get you very far as a leader. Also, the ability to give and receive feedback and practicing clear and concise communication is instrumental to the success of all. Always commend when appropriate, promote if needed, and provide constructive criticism.

Can you open up about a time when you had a really close call with the business?

When I hired my first employee in 2018, I had to create a group NPI (National Provider Identifier). Prior to starting a group practice, I had an individual NPI. At the end of my first year as a group practice, I received a letter from Medicare that caused my stomach to drop to the floor. Medicare was recouping/clawing back $20,000 of previously paid and processed clams!! The explanation was that I had failed to use our new Group NPI on my Individual Claims.

There were weeks of anguished calls, tears, and pleads as I spent hours on the phone with Medicare/Novitas. I had to return the money in it’s entirety or else I would lose my Medicare contract and suddenly terminate our vast majority of Medicare clients.

Luckily, from a young age, I had always maintained a cushion in my bank account. My cushion just happened to be $20,000-the exact amount I needed to return to Medicare.

Upon further discovery, I learned I could re-submit all claims under our Group NPI. I returned the funds, re-submitted claims, and luckily received the majority of the $20,000. Had I not maintained a cushion in my business account, I could have very well gone out of business.

Contact Info:

• Website: https://www.silverliningsmh.com/
• Instagram: https://www.instagram.com/silver_linings_counseling/
• Facebook: https://www.facebook.com/SilverLiningsCounselingLLC/
• Linkedin: https://www.linkedin.com/in/samantha-silverman-lcsw-6927ba184/
• Twitter: https://twitter.com/SilverLiningsMH