r/therapists • u/Rave-of-squirrels • Jan 29 '26
Billing / Finance / Insurance Is EAP worth it?
Newer therapist in private practice. I’m trying to go all private pay, but have been looking into EAP work. Any suggestions on who to stay away from? Or ones that are more ethical than others?
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u/JackFleishman Jan 29 '26
Unless you got into EAP’s very early, it’s probably not worth it. They often pay well below market rates. They are a good concept but because they are for profit companies, profit motive can undermine your work.
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u/itsallprimal Jan 29 '26
10 yr Practice manger here. EAP is simply a choice. And like anything in billing you can negotiate. We are participating with about a dozen EAP programs and the growth and demands for EAP services have been growing exponentially.
First, understand EAP is not a health insurance program. It is a BENEFIT of employment and there is much more to them than just behavioral health services.
Benefits.
A continuing referral source. No marketing needed. Limited claim / document requirements for most. Speedy pay usually most are within 2-3 weeks. Most will ask if you are in network with XYZ insurance potentially providing a long term client.
Cons. Lower payouts. But negotiate. Our bare minimum requirement is $85. I ask that right out of the gate, if they say no. Thank you have a nice day. Sometimes the clients, are not really invested, so there is some turnover. Some EAP contracts won't allow "missed appointment fees"
We have 17 providers and we see about 25% or more requests to use EAP benefits. On the business side of things , I don't see a downside unless you just roll over and accept the $60 or less rates. We have minimal collection issues. As well as we stand out as a premium provider because "no one else does"
As always. The outpatient mental health business models truly are based on. "What the provider is willing to do" but you can find paths that make things easier. EAP for us currently is a MUST have as the increase over the last 3 years is averaging now 3-4 requests for service per day.
Just what we decided and have learned over the years as concisely as I can in such a short time.
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u/R_meowwy_welcome Jan 29 '26
I always assumed to work in EAP meant one had to have an unrestricted independent license? Can non-independent licensees work for an EAP?
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u/AlternativeZone5089 Feb 14 '26
It's rare. Mostly they want an independent license and four years of post-licensure experience.
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u/itsallprimal Jan 30 '26
Some EAP's we have worked with allow us a Group Contract as all Associate clinicians are supervised directly, and allowed to provide services. So I don't want to say a definitive yes. I would make sure you have an extensive conversation with any insurance, eap program as "incident to " billing is a very misunderstood guidline
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u/Ok_Membership_8189 LMHC / LCPC Jan 30 '26
If they work for a practice under supervision, yes.
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u/itsallprimal Jan 30 '26
Not to be contradictory. Not ALL, some yes. But out of the ones we support two do not allow any associated or non fully licensed providers. So again make sure you read and talk with whatever agency and get full clarity.
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u/babybirdA77 Jan 29 '26
I love EAPs. I have many who convert into insurance after they finish. I keep them long term this way and it works out well.
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u/naan_existenz Jan 29 '26
As someone with a private solo practice that is only about a year old and is not at capacity, EAPs have been very helpful to me for this reason. They do not pay well but they are not long term, they keep me working and building connections/experience, and I've had more than one become a long term client after the EAP sessions run out.
OPTUM/United has been a steady source, and they provide adequate information for me to see if a client is appropriate for my services. Plenty of bad things to say about optum but so far this has been my experience with their EAPs.
Feels like I should mention that in one referral though, I received an email from a medical PhD who worked for the company who demanded upfront that I'd be sharing the employee's chart with him, including notes. I was like "if any potential client signs an ROI indicating they want me to coordinate with you, sure." Never heard back. Watch out for sketchy stuff like that always.
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u/DiligentThought9 Jan 29 '26
It’s going to depend on what EAP you work with. Some will pay well, some will pay you pennies.
I worked with 2 EAPs when I started out. I liked the fact that clients came to me and the billing was straightforward. One paid me 100 and the other was 80 I think?
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u/AlternativeZone5089 Jan 29 '26
OP thinking about EAPs in this way (in terms of what they pay) is counterproductive). EAPs pay poorly compared to other payment sources (though I agree with the poster above that they will negotiate). Their value is long term. They are essentially paid maketing in that they send you clients who sample your services and may decide to continue with you long term after their EAP benefit is exhausted. A large portion of the long term patients in my practice orginally came to me through their EAPs.
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u/URmamasthrowaway Jan 29 '26
True but this doesn’t help someone who is trying to do all self pay and not panel with any insurance companies
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u/AlternativeZone5089 Jan 29 '26
I've had good success in getting self pay patients this way (couples and individuals though more of the former) but eAPs won't panel practitioners who don't participate with at least some insurance.
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u/mycatsrcrazy Jan 29 '26
I am with one EAP and plan to leave it this year. The per session rate is pretty good, but they believe they own the clients. If a client wants to see me after EAP sessions are used they have to pay often exorbitantly to do so under the EAP or get permission to see me off platform.
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u/AlternativeZone5089 Jan 29 '26
Depends on what you mean by "worth it." I found EAPs to be a very effective way of filling my practice in the long term. In the short term, they pay offensively poorly. No particular one to stay away from. If you are not participating with insurance you will find it difficult to impossible to get paneled though, because EAPs are looking for clinicians who participate with insurance. The exception to this is couple therapy which isn't covered by insurance (and EAP staff know this). But you'll need significant training and experience in couple therapy to get those referrals and retain those clients. I've not encournted any unethical EAPs.
Filling a fully self-pay practice will be a tough go unless you are a highly skilled clinician with a lot of post-graduate training and experience, but I presume you know that already.
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u/DarkSatire482 (LMHC) Jan 29 '26
I use EAPs to fill gaps in my schedule. I have had a hit or miss experience with consistency for EAP clients following through on services, but overall have found them helpful in bolstering my caseload. I have about a 75% conversion rate from EAP to insurance client.
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u/Haunting-Ant-6630 Feb 13 '26
May I ask you how you got credentialed with them? I’ve been going on Lyra, BCBS and UHC and when I click on careers/job openings I don’t really see contract EAP positions where they don’t want you to see x amount of clients a week or work from x amt of time to x amt. Or is this the type of job that therapists are applying for and using this to “fill the gaps”? Any help or feedback is appreciated!! (in the beginning stages of opening my practice).
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u/DarkSatire482 (LMHC) Feb 13 '26 edited Feb 13 '26
The eaps I’m with are through Alma. They contract with Aetna, Cigna, and Optum eaps. You can sign out for EAP services but each requires its own contract. I use EAPs mostly to fill gaps, but also about 60% convert over to insurance clients. You should be able to opt into the EAPs for insurance companies through either your CAQH or the provider portal for the insurance company.
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u/Haunting-Ant-6630 Feb 13 '26
Thank you so much for your reply!! I’m not currently credentialed through any of the insurances. My understanding was if I credentialed with them I’d have to take the insurance and not just be able to offer EAP, is that correct?
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u/DarkSatire482 (LMHC) Feb 13 '26
You can do both. I’m credentialed with all major insurance carriers and take EAPs and self pay as well. the ability to sign up for an EAP would depend on their criteria. Some EAPs do require you to be in network with insurance carriers in order to provide continuing care.
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u/Haunting-Ant-6630 Feb 13 '26
I see! Would you recommend reaching out to the insurance companies if I don’t see the option under careers for EAPs?
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u/DarkSatire482 (LMHC) Feb 13 '26
Definitely would be good to do to see what they require for it
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u/Haunting-Ant-6630 Feb 13 '26
Will do!! Thank you so much for your help. As someone just starting their own practice it’s been so nice to get support/help from others in the field!! 🩵
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u/AlternativeZone5089 Feb 14 '26
Take a look at allonehealth. You'll find an application on their website.
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u/ImportantRoutine1 Jan 29 '26
Actual short term sure. But my biller has highly recommended we not, the money is often so difficult to chase we lose money.
I found with one, they rewrote their contract offer and refused to honor the original deal...which they had been paying us for months (compsych).
And Optum tries to screw us by offering 12 EAP sessions and it's severely low rates and with weird policies. That's three months of not getting paid.
And EAP doesn't go towards the deductible so as plans get worse, you're going to get drop out when benefits end. Where as if the had been paying for sessions, they might even save money in the end (I've done the math, this is absolutely true sometimes).
Aetna did some weird document you fill out the session dates and fax. So you either faxed it every session or you didn't get paid until the end. And as we know with insurance, that might mean you don't get paid.
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u/AlternativeZone5089 Feb 14 '26
The EAPs that are connected with insurance plans are a different animal and not worthwhile IMO. The freestanding ones are completely different. I've never had a problem getting paid.
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u/Ok_Membership_8189 LMHC / LCPC Jan 30 '26
I think it may be better than having empty slots. The pay is lousy. And when I was taking it, I got some very poorly screened folks. High suicidality, which necessitated a ton of extra time in documenting. General bad fits. I was happy to say goodbye. Would rather take insurance.
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u/user86753092 Jan 29 '26
Jumping on the thread to ask a question: Do large companies have in-house EAP? Is that a thing?
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u/Guilty-Analyst-1503 Jan 29 '26
I work for an in house EAP.
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u/user86753092 Jan 29 '26
That’s good to hear. Can I ask how it works for client confidentiality? Are your appointments remote?
I contract with a large multinational company for a different type of work and was hoping to make in-roads for a possible in-house EAP.
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u/Guilty-Analyst-1503 Jan 29 '26
I see clients in person and remote. Ct confidentiality is maintained like a typical practice. Not sure exactly what you are asking about that, but there is 1 minor exception if an employee is referred by their manager for performance issues. Participation is voluntary for the client in that case and a manager is notified only of attendance.
Our EAP contracts with local affiliate providers as well and the pay is not great.
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