Seeking Advice: Help with Utility Interruption Claim as a Solo Private Practice Provider
Summary: After switching to full-time private practice, my office has lost power for over a week, just as I was gearing up for a financial boost. I’ve filed a claim for lost income, but how can I prove to my insurance agent that my earnings were set to increase significantly?
Hi everyone,
I’m a private practice psychologist working solo, providing therapy and assessment services. Until December of last year, I was under contract with the VA Hospital, balancing my time primarily with them. However, I decided to fully invest in my private practice starting in January. I worked hard to establish my LLC, get credentialed with managed care and Medicaid, ramp up my marketing efforts, and build a waitlist. Although my time with the VA was fulfilling, my real passion lies in pediatrics and working with ADHD and autism.
After a slow start, I finally got approved at the beginning of February for most managed care networks and began seeing patients from my waitlist. My calendar was filling up, and I was excited to finally kick off my first week as a fully booked independent clinician. That excitement was short-lived.
On February 17th, a fire in the commercial junction box behind my office caused a power outage that has lasted over a week. As a result, I had to cancel my entire first week of appointments. The issue turned out to be more extensive than anticipated, and repairs are projected to take weeks. Fortunately, I have coverage through State Farm for business interruptions due to utility outages, so I filed a claim for the earnings I’d lose during this time.
The challenge now is proving my lost income without seeming untrustworthy. I’ve created a basic table showing patient initials, appointment dates, types of appointments, and expected charges. However, my insurance agent informs me that this isn’t sufficient documentation. Since these were my first scheduled appointments, confirming my expected earnings based solely on historical data doesn’t reflect my current potential.
Due to privacy regulations, I can’t share my appointment calendar or any patient correspondence to substantiate my claims. My agent suggested providing last year’s tax returns, but I explained multiple times that my previous income won’t accurately represent my current situation as I transitioned to full-time private practice. I even mentioned that as my own tax preparer, I don’t have conventional profit/loss statements to provide.
My income has been minimal thus far—approximately $325 per week—given I’ve been in a startup phase, and I haven’t had budget for outside help yet.
Bottom line: the power is still off, and I’m rapidly depleting my savings as State Farm’s response feels stalled. Should I create a formal profit/loss statement based on my anticipated earnings and the canceled appointments? What differentiates that from my initial table, aside from its appearance? The agent has stated that they won’t proceed until I provide that document, along with an estimate on the timeline for repairs.
I’m genuinely struggling, and my finances are dwindling fast. I can last a little longer, but I’m running low on funds.
Any advice or guidance would be incredibly appreciated. Thank you!
I’m really sorry to hear about your situation; it sounds incredibly frustrating and stressful, especially as you’ve worked so hard to set up your practice. Here are some suggestions that might help you navigate the claims process with State Farm and demonstrate your anticipated loss of income:
Detailed Profit/Loss Statement: Since your agent insists on a formal profit/loss statement, you might want to create one that reflects your estimated income based on the appointments you had scheduled. Use your planned appointments, the types (therapy, assessments, etc.), and corresponding fees to project your potential earnings for those weeks. Clearly label it as an estimate based on your planned appointments—and explain that you are unable to provide historical income as this is your first month of actual practice. Make sure to distinguish it as projected income versus past income.
Documentation of Waitlist and Marketing Efforts: Provide documentation of your marketing efforts (like emails, social media posts, ads) and your waitlist. This can help substantiate that you were in a growth phase and had the potential for higher income. Any communication with prospective clients about appointments can add weight to your case without violating patient confidentiality.
Potentially Use A Business Advisor: Consider reaching out to a business advisor or a service that specializes in helping small business owners. They can assist you in crafting your documents properly and may even understand the insurance claims process better.
Email Correspondence with Patients: If you have any form of communication with potential clients confirming their interest in appointments, this could support your claims. Ensure to remove any sensitive personal information before sharing.
Professional Endorsements: If you have colleagues or supervisors who are willing to provide statements about your schedule or expected billing rates, that might help as well. This could be more informal but might add credibility to your claims.
Insurance Policy Review: Review your insurance policy closely, and check any clauses around business interruption. Understanding what is required specifically for your case might help you present your claims more effectively.
Follow Up Consistently: Keep pushing for answers with the building management about the estimated timeline for repairs. Documenting this in your communication with State Farm could further demonstrate the urgency of your case.
Seek Financial Assistance: While you work through this, consider applying for short-term financial assistance, community grants, or even emergency loans for small businesses. It might be a way to keep you afloat while dealing with the bureaucratic issues.
Patience but Persistence: Remember that this process can take time, and being persistent yet patient in dealing with State Farm may yield results. Make it clear that time is of the essence due to your financial situation.
I hope these suggestions can help you compile the necessary documentation and keep you afloat during this unexpectedly tough time. Good luck.