The Psych Billing Coach: Fighting Insurance Giants and Venture Capital Platforms with Susan Frager, MSW - Part 1

The Psych Billing Coach: Fighting Insurance Giants and Venture Capital Platforms with Susan Frager, MSW - Part 1

In this episode of the "Therapists Unchained", host Sivie Suckerman interviews Susan Frager, MSW, widely known as the "Psych Billing Coach". Susan shares her journey from working as an MSW in a high-stress managed care environment to building a business that helps therapists navigate the complexities of psychiatric billing. The conversation tackles the systemic issues clinicians face with insurance companies, including unresponsiveness, illegal practices, and the rise of venture capital-backed mental health platforms.  - Susan Frager I’m a clinician at heart, but am deeply interested in the finances and management of behavioral health practices and the toxic healthcare policies that cause clinicians to lose sleep and burn out. I practiced as a licensed clinical social worker before accidentally being roped into working for a managed care system in the early 1990s – where I saw just how toxic things really were. I left and operated a mental health billing service from 1998-2024, transitioning to being a full time PsychBilling Coach beginning in 2022.  As “The Psych Billing Coach”, I offer a hybrid approach. You do your credentialing & billing – you keep as much income as you can. But when things get rough…you call in someone to take over the stuff you don’t know. Because you don’t know what you don’t know – and you probably don’t want to know it if it’s esoteric enough! I help with everything and anything. From credentialing, Medicare / Medicaid / Tricare enrollment, fixing data problems, electronic data interchange issues, selecting and setting up the best EHR for you, coding, collections issues, scaling and managing group practices, teaching not just billing but revenue cycle management, fixing rejections and denials, supervisory billing problems, audits/documentation, and fighting clawbacks. And, of course, fighting for reimbursement increases and detangling yourself from the venture capital platforms.  The dormant social worker in me has awakened since becoming a full-time consultant and trainer, and I spend time working on advocacy projects as well. And, there are times when consultations do turn into coaching – because I find it really sad just how many clinicians conclude that your problems with managing your practice are somehow a personal failure, as opposed to a highly toxic system that is operating as designed – to keep profit at the top of the food chain.  If you DO want to learn more, I’m developing The Rescue Biller® and it’s open now to Beta members. It’s a treasure trove of information, available 24/7 with a membership subscription. The Rescue Biller has downloads, videos, and tons of answers to What do I do IF?  We’re developing a community where billers, credentialing experts, administrators, and clinicians freely mingle their knowledge. Once a month we have a no-charge Zoom “Open House” where we discuss problem situations and brainstorm how to solve them, without sharing protected health information. People love the ever-growing list of insurance executive names and verified emails – for use when you just need someone to respond and fix your issue, because no one in the customer service center in Asia will be able to! My method, which I call my “Executive Badass Complaint Method,” was featured in the New Yorker in December of 2024 – after the murder of the United Healthcare CEO.  I don’t pull any punches – and I’m known for a rather sarcastic way of looking at these things.  Links: My main website: https://psychbillingcoach.com/ [https://psychbillingcoach.com/] Services page:  https://psychbillingcoach.com/services/ [https://psychbillingcoach.com/services/] My blog: https://psychbillingcoach.com/billing-blog/ [https://psychbillingcoach.com/billing-blog/] Schedule a consultation:  https://psychbillingcoach.com/schedule/ [https://psychbillingcoach.com/schedule/]   And here are a few I’ve done specifically about the platforms: * https://psychbillingcoach.com/tech-platform-money-trail/ [https://psychbillingcoach.com/tech-platform-money-trail/] * https://psychbillingcoach.com/mega-platform-billers-perspective/ [https://psychbillingcoach.com/mega-platform-billers-perspective/]  (part 2 of this is the infographics only: https://psychbillingcoach.com/minor-differences/ [https://psychbillingcoach.com/minor-differences/]) *  https://psychbillingcoach.com/medicare-vs-the-mega-groups/ [https://psychbillingcoach.com/medicare-vs-the-mega-groups/] This episode was produced and edited by Sivie Suckerman, MA, LMHC, ACS

Fighting the Therapist Farms: Why Small Group Practices Matter with Jessica Frick, LPC

In this episode, host Sivie Suckerman, LMHC welcomes her guest, Jessica Frick, LPC.  Drawing on her background in community mental health, Jessica shares vital updates on her macro-level advocacy work within the Mental Health Insurance Reform Task Force and the Pennsylvania Counseling Association. Their conversation focuses on the current challenges mental health professionals face regarding insurance companies and venture capital-backed platforms. Jessica and Sivie discuss these "therapist farms" that exploit clinicians and complicate the therapeutic relationship by causing unpredictable billing issues for clients. They also raise alarms about the "uberization of therapy" and vertical integration, noting that insurance companies are increasingly buying out mental health agencies and pressuring providers to contract through VC platforms.  --- Jessica Frick, LPC Jessica Frick is a licensed professional counselor (LPC) in Pennsylvania and group practice owner. Jessica is a member of the Pennsylvania Counseling Association's Goverment Outreach Committee and works with the Legislative Subcommittee to advocate for reform within PA. Jessica is also one of PA's state leads within the Mental Health Insurance Reform Task Force (MHIRTF). As an experienced therapist with over five years of practice, I specialize in working with adults who have emotionally immature parents or have experienced emotional abuse during childhood. I am committed to helping clients heal and thrive through validation, support, and education about their backgrounds and history. Utilizing Acceptance and Commitment Therapy (ACT), I empower individuals to navigate through challenging emotions, break free from self-limiting beliefs, and prioritize their own well-being. Through compassionate guidance, validation, and skills exercises, I assist clients in reconnecting with their emotions and rediscovering their innate strength. If you're seeking a safe space to heal from past wounds and create a more fulfilling life, I invite you to embark on this transformative journey with me. Metamorphosis Counseling [https://www.metamorphosiscounseling.net/] This episode was produced and edited by Sivie Suckerman, MA, LMHC, ACS

Data, Dollars, and the Future of Therapy: The Therapist Resource Institute with Sharon Harper, LCSW

In this episode of Therapists Unchained, Sivie Suckerman interviews Sharon Harper, a licensed clinical social worker and the founder of the Therapist Resource Institute (TRI). The conversation explores and emphasizes the necessity of reclaiming professional autonomy and building sustainable careers through authentic human connection and systemic advocacy while also delving into the Therapist Resource Institute as a national platform designed to unify mental health professionals across all licenses and career stages. Harper explains that she created the organization to combat the fragmentation of the field and the growing influence of venture-backed tech platforms that often exploit clinician labor and client data. The sources describe TRI as a supportive professional community that offers practical tools, such as referral networks and business vetting, while aiming to provide a collective political voice through future lobbying efforts.  -- Sharon Harper, LCSW, is a Licensed Clinical Social Worker, private practice owner, and the founder of the Therapist Resource Institute (TRI), a national platform created to connect therapists across all states, licenses, and career stages. TRI focuses on strengthening referral networks, providing practical resources, and building collective voice in a field that is often fragmented. Sharon is also the owner of Sharper Counseling and Sharper Practice Consulting, where she provides therapy, supervision, and consulting to clinicians looking to grow sustainable practices and better navigate the business realities of mental health care. Her background includes work in an acute psychiatric setting, child and family services, and intensive in-home care, giving her a broad view of the system from multiple angles. Known for her direct and practical approach, Sharon speaks openly about the challenges therapists face—from burnout to business confusion to industry shifts and is focused on building solutions that are grounded, collaborative, and actually useful. Please check out the Therapist Resource Institute's website! https://therapistresourceinstitute.com/ This episode was produced and edited by Sivie Suckerman, MA, LMHC, ACS

Dismantling the Status Quo: The People's Solidarity Fund with Nicole Sartini, LPCC, IMHP

*The audio in this episode is not my favorite. Thanks for your understanding!* In this episode, host Sivie Suckerman welcomes her first-ever return guest, Nicole Sartini. Nicole is a licensed professional clinical counselor, integrated mental health professional, and a fierce advocate for social justice and health insurance reform based in Louisville, Kentucky. Following up on their previous conversation from August, Nicole shares vital updates on her macro-level advocacy work within the Mental Health Insurance Reform Taskforce, to challenge corporate greed and the monopolization of the behavioral health profession. Sivie and Nicole dive deep into the newly formed 501(c)(3) nonprofit, Build Better Health, and explore a groundbreaking, cooperative alternative to traditional health insurance known as the People Solidarity Fund. --- Nicole Sartini is a licensed counselor, mental health leader, systems reform advocate, and social impact entrepreneur working to transform how healthcare is structured, funded, and delivered in the United States. She is the Founder and Executive Director of Build Better Health, a nonprofit advancing equitable, transparent, and sustainable healthcare systems, and leads the Mental Health Insurance Reform Task Force, a national, multi-discipline coalition of provider advocates spanning more than 40 states. Through this work, she focuses on enforcing parity laws, challenging harmful insurance practices, and advancing structural reform that protects both clinicians and the communities they serve. Nicole is also the Founder of the People’s Solidarity Fund, a cooperative healthcare model being developed as an ethical, community-centered alternative to traditional insurance, designed to bring care, funding, and decision-making back into right relationship. With over two decades in the mental health field, including building a large integrative group practice called Bridge Counseling and Wellness based in Louisville, KY, Nicole has transitioned from clinical care to focusing her work on advocacy, coalition building, and system design. Her work is rooted in the belief that healthcare can be mutually respectful, collectively minded, and heart-led in a way that puts people over profit and truly serves the whole.   Links: MHIRTF is currently conducting a national provider survey to better understand how insurance practices impact clinicians and the communities they serve. This data supports ongoing advocacy efforts and helps inform more just and equitable policy solutions. Take the survey: https://forms.gle/bRNdaLhfk9mYZTok6 [https://forms.gle/bRNdaLhfk9mYZTok6] Clinicians who are interested in learning more or participating in this work are invited to complete the Get Involved form and attend our monthly national meeting. Meetings are held via Zoom on the second Wednesday of each month at 11:00 AM ET and include updates, shared learning across states, and opportunities for deeper engagement. Get involved: https://bintake-formbh.zapier.app/get-involved [https://bintake-formbh.zapier.app/get-involved?utm_] Register for meetings: https://us06web.zoom.us/meeting/register/9a3WuXZmRjyxPXNlHRU0-A [https://us06web.zoom.us/meeting/register/9a3WuXZmRjyxPXNlHRU0-A?utm#/registration] Build Better Health website: www.buildbetterhealth.org [http://www.buildbetterhealth.org/] Bridge Counseling and Wellness website: www.bridgemndbody.com [http://www.bridgemndbody.com/] Mental Health Insurance Reform Task Force on Facebook: https://www.facebook.com/MentalHealthInsuranceReformTaskForce [https://www.facebook.com/MentalHealthInsuranceReformTaskForce] This episode was produced and edited by Sivie Suckerman, MA, LMHC, ACS

If it Sucks, Fix it: Taking Back our Professional Associations with Shannon Thompson, LMHC

In this episode, Sivie sits down with Shannon Thompson, LMHC, Executive Director of the Washington Mental Health Counselors Association (WMHCA), the state chapter of the American Mental Health Counselors Association, to explore and dismantle the typical narrative around professional organizations. Shannon explains how the WMHCA has evolved into a "unicorn" in the field by employing a paid leader who is also a licensed clinician. They discuss the role of professional associations for clinicians, limitations and challenges of state advocacy, the myth of the workforce shortage, how to be more engaged in your local chapter, and why "neutrality" is no longer an option for organizations committed to equity.  --- Shannon is a licensed mental health counselor (LMHC) and a child and adolescent mental health specialist (CMHS).  Shannon graduated from Argosy University with a Master's in Mental Health Counseling in 2006.  She spent many years in community mental health before opening a private practice in 2013.  Her career has primarily been focused on serving children, adolescents, and their families.  Shannon has been part of the WMHCA board since 2016.  She joined originally as a volunteer and was the workshop chair.  In 2018 she became the Education and Advocacy Director and more recently has been promoted to Executive Director of the WMHCA board. Learn more about the Washington Mental Health Counselors Association (WMHCA) by visiting their website: www.wmhca.org [https://wmhca.org/] This episode was produced and edited by Sivie Suckerman, MA, LMHC, ACS