Dear Dangerously in Love with Finance,
We’re two psychiatric-mental health nurse practitioners (PMHNPs) who started our own private practice three years ago. We love what we do—helping people through mental health care is our passion—but the financial side of running a business has been a constant struggle.
Our practice is technically profitable, yet it always feels like we’re just scraping by. No matter how many hours we put in, our bank account never seems to reflect the effort.
Insurance is a headache—reimbursement rates are all over the place, and chasing down claims feels like a full-time job in itself. We do offer cash-pay services, but we’re constantly second-guessing our rates, afraid that charging too much will drive potential clients away. Meanwhile, billing, bookkeeping, and budgeting feel overwhelming. We don’t have a strong handle on financial metrics like profit margins or overhead costs, which makes it even harder to know where to make changes.
We’ve thought about hiring a financial consultant, but the expense makes us hesitate. We know we need to make some financial shifts, but we’re not sure where to start.
How can we improve the financial health of our psychiatric practice so we can actually experience the freedom we hoped for when we started this journey?
~Overworked and Underpaid PMHNP
Dear Overworked and Underpaid PMHNP,
First, let me acknowledge that you’re not alone. Many psychiatric-mental health nurse practitioners (PMHNPs) struggle with financial management in private practice. Matter of fact, there are many private practices within other specialties that are struggling with this same issue.
But guess what? You don’t have to stay in this overworked and underpaid space. You guys just need to make some changes. Small, strategic changes can lead to a big financial impact without compromising patient care. Let’s break this down into actionable steps:
1. Optimize Your Pricing Model
Since you’re balancing insurance reimbursements and cash-pay services, your rates need to reflect the value of your expertise. Many PMHNPs undercharge, fearing they’ll lose clients.
Don’t do this!!! Instead of lowering rates, consider adding value—such as longer initial evaluations. Also, research market rates in your area to ensure you’re not undervaluing your services.
2. Streamline Insurance Billing & Claims Processing
Delayed or denied claims can wreak havoc on cash flow. If you’re handling insurance billing yourself, you might be losing money without realizing it. And you are losing time – time you can be using to work on your private practice not in your private practice.
Investing in a billing specialist or an automated system can significantly improve your reimbursement rates. Many PMHNPs find that outsourcing claims processing pays for itself by reducing unpaid claims and speeding up revenue collection.
3. Reduce No-Shows & Late Cancellations
Missed appointments directly impact revenue. Implementing a firm cancellation policy—with automated reminders—can decrease no-shows.
Some private practices also require a deposit for new patient appointments to ensure commitment. A small tweak here can lead to a significant increase in billable hours.
4. Track Key Financial Metrics
Many PMHNPs focus on revenue but overlook profit margins. Understanding your operating costs, net profit, and break-even point is essential. Regularly review your profit-and-loss statements and identify where you can cut unnecessary expenses. A simple budgeting tool or financial dashboard can give you better control over your cash flow.
5. Offer Group Therapy or Workshops
Adding high-value, low-effort services—like group therapy, medication management workshops, or mental health coaching—can boost revenue without requiring significantly more time. Group sessions allow you to serve more clients while maximizing income per hour.
6. Maximize Tax Deductions
Many PMHNPs leave money on the table by not fully utilizing tax deductions. Business expenses like home office costs (for telehealth), continuing education, licensing fees, and even professional liability insurance may be deductible.
7. Improve Patient Retention & Referrals
Acquiring new patients is expensive, but retaining existing clients is cost-effective. Establishing strong patient relationships, offering follow-up programs, and creating a referral incentive for existing clients can ensure a steady revenue stream.
8. Get Financial Support & Education
If hiring a full-time financial consultant feels out of reach, consider working with a remote CFO, that provides both financial guidance and accounting tailored to therapists. Healthy Bodies of Finance provide resources tailored to mental health providers, helping you make data-driven decisions that enhance financial stability.
Looking for assistance in making small changes, so you can feel and experience big impact. Schedule a call with and get on my calendar.
Hope this tips helps, reach out if you have any additional questions. As this is what we do….
Mindful Financial Tips:
By making small but intentional financial shifts—optimizing your pricing, improving billing efficiency, and outsourcing—you can create a sustainable and profitable psychiatric practice. Your skills as a mental health provider are invaluable, and your financial well-being deserves just as much attention as your patients’ mental health.
Running a successful psychiatric private practice isn’t just about providing exceptional care—it’s about ensuring your finances are just as healthy as your patients. At Healthy Bodies of Finance, we specialize in accounting, bookkeeping, and financial management designed specifically for therapists and PMHNPs in private practice.
You’ve worked hard to build your practice. Now, it’s time to make your money work for you.
This article is designed to provide information only and should not be considered legal or tax advice. Because of the complexity of the law and the variables in your own personal tax and accounting situation, you can’t rely on our advice specifically related to your unique circumstances. In order to get the best tax savings and legal advice available to you, you should consult with your own accountant, attorney or advisor regarding your particular facts and circumstances. Healthy Bodies of Finance is an accounting firm that specializes in working with health and wellness providers. We provide monthly accounting & bookkeeping services and financial education. For more information on our specialized services for health and wellness providers please contact us at [email protected]