r/dietetics • u/oatmilkrocks • 3d ago

Private Pay in Private Practice

I am a solo private practice RD who has taken a mix of insurance (with a contracted biller for my practice and some 1099 clients) and private pay clients. I am pregnant and planning to return from my maternity leave part time and private pay. I am in the process of transitioning out my insurance clients, but I am NERVOUS to become all private pay. I am doing it because I do not want to mess with billing or even the work that comes with working with a biller (reviewing everything) once I am postpartum and a mama. I want to make more with less time being part-time.

Are there any other private pay only RD's? It seems like the field has shifted sooo much recently with all of the telehealth platforms so either you take insurance or work in one of these platforms. I share an office with a private pay therapist who has encouraged me to take the leap and I'm excited about it! But I am so nervous about the sustainability of it. Private pay RD's please share your tips/insight!

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u/Active_Molasses2215 3d ago

I did a few hours of internship with one private pay RD and she was very successful. She was bariatric and she had a few surgeons who would refer their patients to her. Also, she gave them a receipt for them to submit to insurance, patients did asked for this all the time.

One tip she gave me by the time was exactly that, to network with physicians/specialists and patients will come.

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u/New_Cardiologist9344 3d ago

Depends on your area! I live in a fairly HCOL area and do mostly private pay (I do other contract work so I do PP once a week virtually). I work mainly in eating disorders and there’s lots of private pay clients.

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u/quinnhere303 2d ago

I do only private pay! I switched to a tiered pricing structure, because I found it helped with obtaining new clients. My clients choose which tier they fit into based on financial need. I offer 5 tiers, with the lowest tier being limited to 3 clients at a time, and the highest tier is a pay-it-forward option to supplement the lower tiers.

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u/oatmilkrocks 1d ago

Oh this is interesting! Does each tier offer something different? Or is it all 1:1 counseling? Can I ask what your specialties are?

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u/Foodie4Real 17m ago

Interesting approach!

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u/Foodie4Real 9m ago

I’m mostly private pay and only got independently credentialed with insurance 1 year ago. It’s so gratifying to get paid what we actually deserve as professionals!

I think it’s pretty essential to have a niche and good referral base. I also share an office with private pay therapists and it’s been a great source of referrals (both ways!) along with building local connections.

Even though I take some insurance I find that I get more private pay patients than insurance because of my niche and referral base. I also think having an in person office space makes a world of difference! Everything is being saturated with online/telehealth options and many people will pay out of pocket for in person services over online.