“Caleb, I know you have a business to run, and I know you probably just thought it was a credit card, but when you charged my card, you charged my debit card and wiped out our funds for the rest of the month.” My heart sank. I realized that I had caused my client a difficult hardship. I profusely apologized and we worked out how to go forward both financially and therapeutically.
There are plenty of mistakes that I have made along the way in my private practice. One of them was not putting into place financial policies early on to guide me and my clients when it came to receiving payment (Taking Payment – Part 1). Another one was not containing my countertransference when it came to the financial arrangement of our therapeutic relationship. Both of these mistakes caused my client harm.
A couple days before getting this call from my client, I was looking at the oustanding balances that were on my books. It was towards the end of the month and bills for the practice were due. As part of the initial paperwork, my clients fill out a credit card form and agree that no-shows and their outstanding balances can be charged to this card. They also agree to pay their fees at the beginning of a session.
Sometimes payment at the time of the session doesn’t always work because I have to wait for insurance tell me what the client’s deductible and/or copay is before I bill the client directly. Consequently, some of my clients had racked up a balance while I waited for insurance to send an explanation of benefits. In the past, I have been lax in enforcing my own policies of charging the card at the time of the session, and so I had missed taking some payments from clients when they were due.
I was anxious about money and was mad at myself for not letting clients get behind in payments. I was also frustrated that a couple of clients had not paid when they said they would. And so, in one fell swoop, I charged these clients’ cards, including the client who called me. I’m not proud of it, but my anxiety, fear, frustration, and shame got the best of me. In the end, my actions were harmful to my client. I had failed to keep my books closely and communicate with my clients about their bills and it had painful consequences.
To insure that I did not harm my clients in the same way in the future, I began to diligently follow my policies. I started charging my client something at the time of the session (meaning the day of or the day after). By being disciplined to charge them soon after the session, it makes it more clear to me and to them where their bill stood. In cases when the copay is unclear, my client and I come up with an agreed upon amount that I charge them after each session. This keeps them from incurring a larger bill in the future for built up past copays.
I also decided never to charge a client for past due amounts without giving them their statement and asking them how to move forward. We work out a way for them to take care of paying it, which may mean that they may set up an installment plan or we even have renegotiated the amount. Even if I do in the end charge the card, there have been multiple calls, emails, and hopefully a conversation with the client that have happened first.
The most important change I made was to make my record keeping a priority. I believe that a clear record of the client’s payments and balance is primarily a therapeutic issue and a way that I care for my client’s wellbeing. Clean book keeping also helps me contain my own countertransference. In the end, I want to do my client no harm, including how I handle taking payment.
Image courtesy of Phillip Taylor via Flickr