Thriving & Surviving in the Age of Managed Care

As a seasoned private practitioner, my disillusionment with the insurance cartel occurred years ago.

managed careDisclosure of confidential information was incessantly required by health insurance carriers in order to process claims.

Submitting mental health invoices for reimbursement carried a certain amount of risk to confidentiality, privacy or to future capacity to obtain health or life insurance or even a job.

Additionally, I was aware of the fact that I was receiving insurance reimbursement rates 60% lower than the standard customary fee for psychotherapy in NYC. As a result, I was burning out working excessive hours to meet overhead expenses and wasting precious time battling it out with corrupt insurance companies who all too frequently deliberately delayed the processing of claims.

When two major insurance companies merged, the fallout became unbearable. The already substandard fee was reduced by 20% and I was struggling to clarify what my client’s new benefits were in the sea of misinformation that lay before me. So I pulled out of all the panels.

Subsequently I went into a panic over my decision. The attrition was overwhelming. I didn’t know if I would be able to attract enough referrals as an out of network provider to sustain my practice. Yet, at the same time, I also felt an urgency to give expression to who I was as a clinician with strong creative and spiritual leanings.

Catapulting into Action

These parts of me felt diluted and made obsolete under the scrutiny of managed care. So, I catapulted myself into action and redid my web site, set up a credit card option for clients, developed two six-week workshops and began writing and submitting articles to web publications.

I also completed a play that has been presented to girls in foster care, as well as girls in a long-term in- patient drug rehab facility.

Writing became a vehicle that helped me effectively define who I am and what I have to offer as a clinician.

The writing of articles, workshops and a play has contributed to my establishing and sustaining my practice as an out of network provider. I discovered that article writing is one of the most cost-effective ways to get free traffic back to your website, acquire back links to your website so as to enhance search engine optimization and to position yourself an as expert within your chosen niche.

It is also a powerful means of solidifying your unique professional identity. While search engine optimization is a critical aspect of generating exposure, the primary intention when writing articles should always be providing quality content that speaks to your reader and reflects a meaningful message you feel compelled to convey as the writer.

Emerson wrote:

“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.”

Taking the risk of pulling out of the insurance panels compelled me to ask myself if I was really being true to myself. When I began my efforts to define and establish my professional voice through writing both creatively and clinically, I felt simultaneously liberated and challenged.

Was who I presented myself to be professionally an accurate reflection of who I really am? If I was going to promote my practice and myself through writing, than I needed to become very clear about how I wanted to represent myself.

If I wanted to have a steady stream of referrals I needed to be willing to stand out by communicating very clearly about those specific areas as a therapist in which I have a genuine sense of competency and interest.

I discovered that writing articles about topics that reflected my areas of specialization meant being more visible about who I am as a clinician with a vested interest in therapeutic theater, treating addictive disorders and drawing on diverse spiritual proclivities as an interfaith minister.

Defining My Niche

Defining my niche through writing was first and foremost, helping me to solidify my professional identity in a very real and tangible way. It was encouraging me to be true to myself, both professionally and personally, by positioning myself as a specialist or expert with specific issues and populations that are ideally suited for what I have to offer.


Thriving & Surviving in the Age of Managed Care

Rev Sheri Heller, LCSW

Rev. Sheri Heller, LCSW, is a seasoned NYC psychotherapist with 25+ years experience in the addiction and mental health fields. Sheri is also an interfaith minister and playwright, and the founder of The Sistah Tribe - Phoenix Project, a therapeutic theater event for at-risk women and girls in the public sector of NYC. For more information, visit


APA Reference
Heller, R. (2016). Thriving & Surviving in the Age of Managed Care. Psych Central. Retrieved on November 26, 2020, from


Scientifically Reviewed
Last updated: 19 Mar 2016
Last reviewed: By John M. Grohol, Psy.D. on 19 Mar 2016
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