Any PMHNPs working for online platforms?

DrCOVID, DNP · Feb 21, 2021

I'm really curious about these as well. I just found a review site and they don't seem that great. I don't know how they could be this sh!tty considering their reported revenue... I remember seeing a review that said "do not work for these companies."

https://www.indeed.com/companies/compare/Talkspace-vs-Betterhelp.com-02e0bc19624873f4-985a42d407680c12

It would probably be best to get hired, work 20 hours and then poach clients to your own private practice. I think there are better smaller companies that pay a lot more.

Taylor Stauffer, MSN, RN, APRN · Feb 21, 2021

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1 hour ago, DrCOVID said:

I'm really curious about these as well. I just found a review site and they don't seem that great. I don't know how they could be this sh!tty considering their reported revenue... I remember seeing a review that said "do not work for these companies."

https://www.indeed.com/companies/compare/Talkspace-vs-Betterhelp.com-02e0bc19624873f4-985a42d407680c12

It would probably be best to get hired, work 20 hours and then poach clients to your own private practice. I think there are better smaller companies that pay a lot more.

Yes TalkSpace reviews have been hit or miss but GetCerebral has pretty good reviews so I wondered!

my biggest question was is 20 hours contact hours/pay hours or is it simply the amt of time spent each week with some of that not including prepwork/documenting.

if you know of any other smaller companies that pay well please let me know! ?

DrCOVID, DNP · Feb 24, 2021

From the reviews I have found on those .coms, I think it is just best to find a smaller group. I was able to get 3 interviews just yesterday in IP states for small groups that are looking for a prescriber they can refer to. They all told me I have complete flexibility, remote work, & I can structure my practice/hours however I like. I'm applying for licenses in NM and CO today/yesterday!

MentalKlarity, BSN, NP · Mar 8, 2021

Cerebral quoted something like $25 a patient. They're very low paying.

Taylor Stauffer, MSN, RN, APRN · Mar 8, 2021

10 hours ago, MentalKlarity said:

Cerebral quoted something like $25 a patient. They're very low paying.

Actually I talked with one of their team members who said it is $90-100/hr! Where did you hear that it was only $25??

MentalKlarity, BSN, NP · Mar 8, 2021

1 hour ago, Taylor Stauffer said:

Actually I talked with one of their team members who said it is $90-100/hr! Where did you hear that it was only $25??

They're telling you by hour because they're giving you the best case for a full schedule.

$25 x 4 (15 min med checks) = $100 an hour.

umbdude, MSN, APRN · Mar 9, 2021

I've heard the same about Cerebral. Another problem with Cerebral is that I think it expects NPs to prescribe controlled, which is something I would not do if it's 100% telepsych.

I've talked to 2 other companies (one has similar model another a bit different), both are based on splits. They'll always give you best-case scenarios, but you can adjust them based on your own calculations. Always ask for local insurance reimbursement rates from the company so you can do your own calculations.

Taylor Stauffer, MSN, RN, APRN · Mar 9, 2021

21 minutes ago, umbdude said:

I've heard the same about Cerebral. Another problem with Cerebral is that I think it expects NPs to prescribe controlled, which is something I would not do if it's 100% telepsych.

I've talked to 2 other companies (one has similar model another a bit different), both are based on splits. They'll always give you best-case scenarios, but you can adjust them based on your own calculations. Always ask for local insurance reimbursement rates from the company so you can do your own calculations.

Yes - but ultimately you have to use your judgement when prescribing medications. I don't see that as much of an issue as the pay.

What do you mean "based on splits"?

Any platforms you would recommend or other companies for telepsych?

umbdude, MSN, APRN · Mar 9, 2021

17 minutes ago, Taylor Stauffer said:

Yes - but ultimately you have to use your judgement when prescribing medications. I don't see that as much of an issue as the pay.

What do you mean "based on splits"?

Any platforms you would recommend or other companies for telepsych?

Unfortunately it's not about judgement but legality per Ryan Haight Act. Ryan Haight is altered d/t covid but it's unlikely that it will continue post-covid. Prescribing controlled without seeing a patient in person would be a violation.

Splits is basically a % you receive from whatever you bill and reimbursed. If you get reimbursed for $100 for a 99214 follow-up and the split is 70/30, you would get $70 for that visit and the practice keeps $30.

Can't really make a recommendation yet since I don't work for one. Definitely interview as many as possible and ask for numbers and data.

MentalKlarity, BSN, NP · Mar 9, 2021

You can be paid 4 ways. All have pros and cons:

Salary - my least favorite, but can be good if you want a "guaranteed" amount each month. The downside is that they can overwork you with no incentive not to...if you are salaried there's nothing stopping them from asking you to see that last minute new patient at 4:55PM.

Hourly - a step up from salary because at the very least if you have to stay late or work extra you get paid for it. That said, they can still overbook you since you are paid by the hour and seeing more patients per hour = bigger profit for them.

Per patient (2 ways) - Per patient ensures you are always paid for the work you do. Every extra walk in they squeeze in or double booking = more pay for you. The downside is obviously that there is no guarantee to your income, as you can have busy days where you make a lot and slow days where you make very little. The two ways are a "split" such as you get 70% of what they bill, or a per patient set fee where you get X amount per new patient and X amount per follow up. Either can be fine as long as the numbers are fair. You want to be above 60% (and definitely higher if it is 1099 with no benefits) for a split, and per patient you'd want to look up local reimbursement rates and ensure the fee per patient at least closely resembles the 60-70% split.

Taylor Stauffer, MSN, RN, APRN · Mar 9, 2021

1 hour ago, MentalKlarity said:

You can be paid 4 ways. All have pros and cons:

Salary - my least favorite, but can be good if you want a "guaranteed" amount each month. The downside is that they can overwork you with no incentive not to...if you are salaried there's nothing stopping them from asking you to see that last minute new patient at 4:55PM.

Hourly - a step up from salary because at the very least if you have to stay late or work extra you get paid for it. That said, they can still overbook you since you are paid by the hour and seeing more patients per hour = bigger profit for them.

Per patient (2 ways) - Per patient ensures you are always paid for the work you do. Every extra walk in they squeeze in or double booking = more pay for you. The downside is obviously that there is no guarantee to your income, as you can have busy days where you make a lot and slow days where you make very little. The two ways are a "split" such as you get 70% of what they bill, or a per patient set fee where you get X amount per new patient and X amount per follow up. Either can be fine as long as the numbers are fair. You want to be above 60% (and definitely higher if it is 1099 with no benefits) for a split, and per patient you'd want to look up local reimbursement rates and ensure the fee per patient at least closely resembles the 60-70% split.

thanks for that detailed explanation!!

What would you say is a fair "per patient" rate and a decent hourly rate for a contract job?