How to Retain Clients When Transitioning to a Private Pay Practice (Without Panic or Guilt)
Breaking up with insurance is a bold move, and if you’ve made it this far, congratulations! You’ve recognized that your worth as a therapist isn’t dictated by insurance reimbursements and that your ability to provide high-quality care shouldn’t be compromised by red tape.
But let’s be real—transitioning to private pay comes with one major fear: What if my clients leave?
The good news? Many of them won’t—if you handle the transition with clarity, confidence, and solid communication. Whether you’re a solo practice owner or leading a group practice, this guide will show you how to:
Retain existing clients through proactive and compassionate communication
Reframe the transition so clients see the benefits of private pay
Set up alternative payment options to make care accessible
Stay confident through objections (without second-guessing yourself)
Let’s dive in!
1. Understand That Your Clients Value YOU—Not Their Insurance Plan
First things first—your clients are here for you. They’ve built trust with you, and their care is about the relationship and results, not just their co-pay.
Mindset Shift: Instead of fearing client loss, remind yourself:
👉 Clients invest in things that bring them value—even outside of insurance.
👉 People pay out of pocket for massages, chiropractors, coaching, and gym memberships—all for their well-being. Therapy is no different.
👉 Your clients deserve high-quality care, and a private pay model allows you to provide that without the restrictions of insurance.
When you own your value, you make it easier for clients to see why continuing with you is worth it.
2. Craft a Strong, Compassionate Client Transition Plan
You don’t want your clients to feel like they’re being pushed off a cliff without options. The key? Proactive, thoughtful communication.
Sample Email to Current Clients:
Subject: Important Update on Your Therapy Services
Dear [Client’s Name],
I want to personally thank you for trusting me with your care. Working together has been an honor, and I remain committed to providing you with the highest level of support.
I wanted to share an important update: As of [Date], [Practice Name] will no longer be in-network with [Insurance Provider]. This decision was not made lightly, but I strongly believe it will allow me to continue offering the personalized, high-quality care you deserve—without the limitations and delays imposed by insurance companies.
Here’s what this means for you:
✅ You can continue therapy with me on a private pay basis at a rate of [$XXX/session].
✅ Many of my clients use their HSA/FSA or submit for out-of-network reimbursement—and I’m happy to guide you through this process.
✅ I am offering limited transitional support options, including [reduced fee packages, extended sessions, or customized payment plans—adjust based on your model].
I know that change can bring up questions, and I want to make this transition as smooth as possible. Let’s discuss any concerns you have in our next session, and I’ll be happy to walk you through your options.
Warmly,
[Your Name]
💡 Pro Tip: Announce the change at least 90 days in advance, with multiple touchpoints (email, session discussions, and possibly a letter for established clients). This builds trust and reduces uncertainty.
3. Be Ready for Objections—And Address Them With Confidence
You’ll get questions, and that’s a good thing—it means your clients want to stay with you! Here’s how to handle some common concerns:
💬 "I can’t afford to pay out of pocket."
✅ Empathetic Response: “I completely understand that finances are a concern, and I want to help make this transition as smooth as possible. Many of my clients use HSA/FSA funds or submit for out-of-network reimbursement, which often covers a significant portion of the cost. I’m happy to walk you through how that works.”
✅ Bonus: Consider offering flexible payment plans or package pricing to ease the transition.
💬 "Why are you leaving insurance?"
✅ Confident Response: “This decision allows me to provide better, more personalized care without the constraints of insurance. Insurance companies often dictate session length, frequency, and even treatment approaches, which limits my ability to fully support my clients. This transition allows me to focus entirely on what’s best for you.”
✅ Key Tip: Keep it about the client’s best interest, not just your frustration with insurance.
💬 "Will you help me find another therapist?"
✅ Supportive Response: “Absolutely. If you decide to transition to an in-network provider, I will make sure you have the resources and referrals to find the right fit. My priority is that you continue receiving care, in a way that works best for you.”
4. Make It Easy for Clients to Stay
You can reduce client drop-off by offering practical ways to continue care:
Superbill Support: Create a simple step-by-step guide on how to submit superbills for out-of-network reimbursement.
HSA/FSA Payments: Educate clients on using pre-tax dollars for therapy.
Bundled Sessions: Offer discounted multi-session packages (e.g., buy 5, get 1 free).
VIP Membership Model: Consider a subscription-based model for continuity of care.
💡 Creative Approach: Some therapists offer “concierge-style” services, like priority scheduling or extended session options for private pay clients—turning this shift into a premium experience.
5. Attract New Private Pay Clients (Without Stressing About Insurance)
Once you transition, your marketing should highlight why private pay is worth it.
Key Messaging for Your Website & Social Media:
No treatment restrictions – Therapy is based on your needs, not what insurance allows.
Complete confidentiality – No mandatory mental health diagnosis on record.
More flexible & effective care – We focus on real results, not insurance quotas.
💡 Update Your Website: Add a “Why Private Pay?” page to educate prospective clients on the benefits.
Final Thoughts: You’ve Got This
Switching to private pay is a business decision, not a betrayal of your clients. A thriving therapist serves better than a burnt-out one, and by taking control of your practice, you’re ensuring you can provide exceptional care for years to come.
By communicating proactively, addressing concerns with confidence, and making the transition easy, you’ll retain more clients than you think—and set yourself up for long-term success.
Ready to learn more? Join our upcoming webinar!:
📅 "Breaking Up with Insurance II: How to Keep & Convert Clients In Your Private Pay Practice"
Happening April 16th @1pm
This webinar will give you even more retention strategies, scripts, and real-world solutions so you can navigate this transition smoothly. Attend live to hear and participate in our Q&A session. can’t attend live? Everyone who registers will receive the recording as well as our Client Retention Guide for Private Pay Practices. Hope to see you there!
