How to Accept Health Savings Accounts in Private Practice (HSA) and Why You Should do it
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Though at any given time about a third to half of my private practice clients pay for therapy with a Health Savings Account, I’m always surprised to find that most therapists I encounter don’t realize that it’s SUPER easy for us to accept this form of payment and get paid our FULL fee. In this video I go over why you need to accept HSA payments and how to do it.
Video explaining Health Savings Accounts (HSA):
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This video is geared for therapists of all kinds, including psychologists, MFTs, LPCCs, social workers, and others in the clinical counseling field.
Welcome to Private Practice Skills! I’m Dr. Marie Fang, psychologist in private practice. I post videos offering tools I learned the hard way about starting and growing private practice so that you don’t have to.
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This video is not intended as professional or legal advice. Be sure to seek the services of a professional if you are in need of them.
You guys. Health savings accounts (or HSAs) are amazing.
In short, HSAs are savings accounts that allow individuals to set aside money tax-free that they can use to pay for out of pocket medical expenses that aren’t covered by their insurance. HSAs can cover expenses like dental bills, prescriptions, chiropractor care, glasses, and yes, mental health care!
This means that for clients with Health Savings Accounts, they can pay for some or all of their therapy using tax-free money!
It’s really easy to accept payment through a client’s HSA.
There are two ways for a client to apply money from their HSA to pay for therapy:
The old-fashioned way: They pay you directly, you give them a detailed receipt, and they submit to their savings account for reimbursement.
The 21st-century way: Running their HSA debit card through your credit card reader.
This process is really similar to how clients can apply for out-of-network insurance benefits. Your client pays your full fee out of pocket and you offer them a detailed receipt called a superbill. Your client then submits the superbill to their HSA to receive reimbursement.
I should do a whole video on superbills. Essentially, they are detailed receipts that include your NPI number, Tax ID number, your client’s name, date of birth, date of service, CPT Code, and the amount your client paid. Most health savings accounts don’t require this degree of detail to reimburse, but I’ve found that a few do, so better to fill out a thorough receipt once rather than having to redo it later.
One note is that if a client is submitting for HSA reimbursement, I don’t include their diagnosis code on the superbill. Unlike out of network insurance reimbursement, this information is not necessary for HSA reimbursement, and it’s their personal protected health information.
Though this old-fashioned strategy totally works and is worth offering to your clients, let me show you a better way that is MUCH easier:
Most clients with HSA or FSA accounts receive a debit card with their account, or they are able to request one. This card only works with approved healthcare providers, so they can’t just swipe it anywhere.
The good news is: therapists ARE approved healthcare providers! But sometimes you have to do a little work on the back end of your credit card service to show you are indeed who you say you are.
I use Square. Which I love. This is not sponsored, I just love square and have used it since I got licensed 4 years ago. If you decide to sign up with square, when signing up just be sure to put your business in the “Medical Services” or “Medical Practitioner” category and you’ll automatically be approved to receive HSA payments through your client’s debit card.
If you selected a different category when you signed up, you can go back and fix it. Simply contact square with the request and they should update it pretty quickly. I had this issue after signing up and Square resolved it within 24 hours.
Although I’ve talked about Health savings accounts in this video, most of what I said here is true for Flex Spending Accounts too, or FSAs.
Hopefully this video has encouraged you to go out and start accepting HSA payments if you haven’t already. Until next time, from one therapist to another, I wish you well.
