Claim OwnershipSit and Stay: Run a Successful Mental Health Practice
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Sit and Stay is a podcast by RipsyTech, offering a seat at the table with our founder and CEO, Dr. Tom Tarshis, alongside product manager, Parker Anderson.
Sit and stay with us as we dive into the heart of mental health practice management and explore the essentials of launching and nurturing a successful practice.
Sit and stay with us as we dive into the heart of mental health practice management and explore the essentials of launching and nurturing a successful practice.
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Continuing from where we left off in last week's episode, diving deeper into some common pitfalls that can occur when setting your charge master, as well as how to know your CPT codes and Relative Value Units (RVUs) are up to date and compliant with insurance requirements.
Sit and Stay is presented by RipsyTech, an electronic health record company committed to addressing the mental health crisis in the United States.
For our first episode focused on billing, Dr. Tom Tarshis and Parker Anderson explore effective strategies for optimizing a practice’s charge master using CPT codes and Relative Value Units (RVUs) to ensure your billing processes are accurate and your compensation structure stays fair.
Sit and Stay is presented by RipsyTech, an electronic health record company committed to addressing the mental health crisis in the United States.
Welcome to the Sit and Stay podcast!
For our first episode, Dr. Tom Tarshis and Parker Anderson discuss the crucial steps of starting a mental health practice.
Sit and Stay is presented by RipsyTech, an electronic health record company committed to addressing the mental health crisis in the United States.
Should your mental health practice be non-profit or for-profit?Your structure shapes your practice for years, so this week we break down the differences: taxes, salaries, grants, boards, loans, and control.
Insurance authorization is a major—and often underestimated—challenge in mental health practice management.In this episode, we unpack a real-world IOP authorization case and explore how insurers process these requests, where delays almost always occur, and what practice owners should be prepared for when offering higher levels of care.Hope you're ready for a clear, honest look at the process.
Insurance contracts can have major consequences for a mental health practice. In this episode of the Sit and Stay Podcast, we break down the insurance contract language clinicians should actually pay attention to: Common “gotcha” clauses, reimbursement rates, documentation requirements, and what to watch for when insurers change terms.If you’re in-network (or considering it), this episode will help you understand what you’re agreeing to and how to avoid costly surprises.
Mentorship and supervision aren’t just for academic clinicians. We unpack how mental health providers can mentor students, supervise trainees, stay current on best practices, and build real community without overcommitting. Plus: what supervision actually means, how payment works in different models, and why being upfront with clients about training level matters.0:00 Introduction1:13 In what ways can providers continue to supervise or mentor over time? 3:10 In what meaningful ways can providers engage in supervision or mentorship?8:07 How can providers early in their careers find mentorship opportunities?11:31 What is the difference between supervision and mentorship? When do they occur?16:07 Do supervisors and mentors usually get paid, or is it a public service?20:11 What are the personal and professional benefits of supervising and mentoring? 25:08 What is a realistic way of fitting supervision and mentoring into your schedule?29:17 The Mental Health Business Moment Of The Week. 35:31 Conclusion
In this episode, Tom explains what credentialing actually is, how CAQH fits into the process, and why timelines can vary wildly. We cover the difference between credentialing and contracting, common mistakes that cause delays, what the upcoming 90-day California law means, and how practices can avoid getting stuck in months-long wait times.0:00 Introduction1:48 The Mental Health Business Moment Of The Week. 5:29 What does credentialing with an insurance company mean? 9:47 What does CAQH stand for, and how does it fit into the credentialing process?18:22 How long can someone expect the credentialing process to take?21:04 Should you push the start date for providers out to when they are credentialed? 23:49 Are there ways to speed up the credentialing process?27:15 What is left to do after getting credentialed and contracted as a provider? 32:05 The benefits of using RipsyTech's billing services!36:42 Conclusion
Thinking about offering ownership or partnership at your mental health practice? In this episode of the Sit and Stay Podcast, we explore four ways to structure partnership tracks for clinicians — including profit sharing, phantom equity, traditional buy-ins, and sweat equity.Dr. Tom Tarshis, founder and CEO of RipsyTech, breaks down how each model works, what to consider legally and financially, and how to decide which structure fits your clinic best. Whether you’re a practice owner looking to reward and retain clinicians or a provider curious about paths to ownership, this episode offers clear, practical insight drawn from years of real-world experience in behavioral health.🎙️ Brought to you by RipsyTech — behavioral health EHR and business support for mental health professionals.
Recorded live at AACAP 2025 in Chicago, we’re catching up after another incredible year connecting with providers, fellows, and clinic leaders from across child and adolescent psychiatry. Parker and Tom share what stood out most at the conference—from the ongoing buzz around AI to the practical realities of running a mental health practice today. We also reflect on what keeps us coming back to AACAP each year: the conversations, the community, and the shared mission to improve care for young people.
In this episode, we break down ownership and partnership structures for private practices: when to offer ownership, how to balance control and profit, and why options like “phantom shares” can motivate without giving up decision-making power.We also touch on legal considerations, attracting top talent, and avoiding pitfalls when adding partners.
Learn the scheduling strategies that keep your mental health practice clinically sound and sustainable. Tom explains how to set smart blocks for intakes vs. follow-ups, choose between 30/45/60-minute sessions, and protect after-school slots without burning out. We also cover when to split parent-only check-ins, why every-other-week therapy can expand access, and how AI-assisted notes change the math on session length and revenue.
In this episode, we break down how to offer reduced fees without risking the health of your practice. Tom explains the difference between sliding scale and other discounts, the pros and cons of income-based models, and alternatives like automatic discounts or referral credits.We also cover the legal and ethical guardrails every provider should know, from documenting requests to setting time limits, and how to budget a realistic “charity care” pool. Finally, we discuss how to communicate these options clearly so patients understand what’s available.
What is a payer mix and why does it matter? In this episode, we unpack how the balance of insurance plans and revenue sources affects your practice’s financial health. Tom shares how he sets fair caps on low-reimbursing plans, explains why transparency with patients matters, and breaks down the pros and cons of accepting more insurers versus negotiating single-case agreements.
Building a budget for your mental health practice isn’t just about tracking numbers—it’s about creating a plan that helps your practice thrive. In this episode of the Sit and Stay podcast, we talk through the key components of a practice budget, how to estimate revenue and expenses, plan for seasonal changes, avoid common mistakes, and use data like payer mix and RVUs to make better business decisions.0:00 Introduction5:55 What are the key components of a mental health practice budget? 16:30 What are the nuances of the components of a mental health practice budget?20:05 How does accounting for salaries and benefits affect budgeting? 23:33 How do you prepare your budget for seasonal variability? 30:25 How can differing patient insurance reimbursements affect the budget?34:06 How do you decide how to divide up your payer mix appropriately?39:35 What budgeting mistakes should be avoided at all costs? 47:47 The Mental Health Business Moment Of The Week. 50:10 Conclusion
Running a mental health practice without a budget? You’re not alone—but it’s costing you more than you think.In this episode, we explore why every mental health practice—whether solo or group—needs a budget. From reducing stress to planning for growth, Tom shares real stories and practical insights about what most providers miss when they skip this crucial step. We also discuss the financial blind spots that can derail your practice and how a budget can give you peace of mind when life throws a curveball.Whether you’re just getting started or looking to grow, this episode will help you build a foundation for long-term success.0:00 Introduction2:41 Why is a budget important for a mental health practice? 7:12 What are some common blind spots when it comes to budgeting? 11:54 How can clinical care improve from budgeting at your practice? 17:17 What are some common mistakes people make when putting together a budget?21:57 Should budgets be reviewed and updated frequently? 25:54 The Mental Health Business Moment Of The Week. 29:04 Conclusion
In this episode of the Sit and Stay podcast, we’re joined by therapist Ida Milani, LMFT, who recently transitioned from a group practice to running her own private practice full time. Ida shares how her early experiences shaped her passion for working with teens and young adults, and opens up about the realities of starting a practice from scratch. We talk about marketing, money, social media, authenticity in the therapy room, and how AI might actually help therapists do more of what they love.
How should you divide the revenue your mental health practice brings in?In this episode of the Sit and Stay Podcast, we explore how to allocate income across clinician pay, operational costs, and business savings, whether you're a solo provider or running a group practice.Tom breaks down his recommended percentages, the psychology behind pay splits, and why clarity around revenue is essential for long-term sustainability.
In this episode, we sit down with Farokh Herfat, Head of Channel Partnerships at Twingate, to explore why modern cybersecurity is essential for mental health providers handling sensitive patient data. Farokh breaks down the real-world risks facing small practices today, from phishing emails to password reuse and unsecured Wi-Fi. He explains how Twingate’s Zero Trust model helps protect both clinicians and their patients without the clunky frustrations of traditional VPNs. We also talk about what sets Twingate apart, why small practices are increasingly targeted by hackers, and how even one wrong click can lead to devastating consequences for your business and your clients. To learn more about Twingate, visit twingate.com.
In this episode, we break down why time-based billing might be hurting your practice, especially if you're a prescriber. Tom explains how using complexity-based billing (with E/M and psychotherapy add-on codes) can significantly improve patient reimbursement and reduce audit risk, even in cash-only practices. We also touch on how therapists can take advantage of interactive complexity codes, and why it's worth explaining this to patients.
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