Do counseling and credit cards mix?

Q: Would it be advantageous to accept credit card payments in my practice?

A: In the past, most health care providers were hesitant to accept credit card payment. Perhaps it was due to a lack of client demand. Also, accepting credit cards for counseling services somehow seemed strange, or else there was lack of knowledge of how to go about it. But today, more and more private practitioners are making credit card payment an option in their practices.

It gives your clients another option to pay for your services, as the use of checkbooks and cash seem to be fading. Moreover, major employers are starting to issue employees debit cards to access their pre-tax dollars contributed to a medical flexible spending account. That way an employee doesn’t have to submit receipts and wait to be reimbursed. We believe this trend will continue, so accepting credit cards would be a good decision.

Accepting credit cards is also advantageous for the counselor. You no longer have to deal with NSF checks (insufficient funds), money is deposited that day, and it helps defray billing costs.

To begin accepting credit cards, you will need to set up a “merchant account.” These accounts can be opened at your local bank or wherever merchant account services are available. But be prepared: These merchant account contracts can be confusing, and prices vary widely. One-year fees can range from $250 to more than $800 for the same services. Costs can include a percentage of the dollar account, item transaction fees, monthly maintenance fees (with a monthly minimum), application and/or membership fees and equipment purchases or leases. So make sure you fully understand all the charges and contract obligations. Ask other counselors in your area what bank or service they use to get the best rates.

Q: American Counseling Association members would like to have a “one-stop” place to access managed care links, billing information, website resources, National Provider Index registration and HIPPA compliance information. Can such a resource be developed?

A: The answer to this question is “YES!” We have just completed the latest update of the list of the 56 largest managed care companies, employee assistance programs and insurance companies. The list includes mailing addresses, phone numbers to provider relations and a direct hyperlink to the provider relations page of each website. Each listing gives information about the number of employees covered, whether national or local, the amount paid to providers and the amount of paperwork.

In most cases a counselor can fill out an application to become a provider online (if credentialing requirements are met and there are openings in the counselor’s market and/or niche). There is also a direct link to the National Provider Identifier, which is now required by Blue Cross/Blue Shield and other insurance companies.

Also included is a link to the Council for Affordable Quality Healthcare. Through CAQH, a counselor can submit a credentialing application that can be accessed by more than 100 insurance and managed health care companies. The links give detailed information about application for NPI and CAQH. A hyperlink to HIPAA is also available.

This one-stop access is provided as a free service to ACA members and is located on the website at You will need to log on first with your member ID or member name and then your password. Call ACA Member Services at 800.347.6647 ext. 222 if you need a password to log on.

We hope this information makes it easier for private practitioners to better serve their clients. We also hope that it will help you make an informed decision on which managed care and insurance companies are best for you to join.

Robert J. Walsh and Norman C. Dasenbrook are co-authors of The Complete Guide to Private Practice for Licensed Mental Health Professionals ( ACA members can e-mail their questions to and access a series of free bulletins on various private practice topics on the ACA website at Letters to the editor: