Getting recruited by a platform, telling them flat out that you live overseas, and then getting cut off anyway is a special kind of frustrating, and it's a big part of why an out-of-network private practice starts to look like the smarter move. In this episode of The Traveling Therapist Podcast, I sit down with Karen Ann Schmid, who came out of retirement at 70 and has been piecing all of this together from a 32-acre farm in New Zealand.
Karen has been through it. A handful of platforms, a cease-and-desist, and a lot of late nights trying to keep seeing her clients while living abroad. We talk about what actually shifted for her once she stopped trying to credential with insurance panels, and what she's building in its place.
In This Episode, We Explore…
Connect with Karen Ann Schmid:
Website: https://www.seensevicesusa.com/
LinkedIn: https://www.linkedin.com/in/karen-ann-schmid-7998ab75/
Connect with me:
Instagram: @thetravelingtherapist_kym
The Traveling Therapist Facebook Group: www.facebook.com/groups/onlineandtraveling/
Signup to learn more about life as a Traveling Therapist: https://www.portablepracticemethod.com/free-training
Revolutionize Your Private Practice with AI Course: www.kymtolson.kartra.com/page/ai
Bill Like A Boss Insurance Billing Community: www.kymtolson.kartra.com/page/blab
Subscribe to the Podcast:
Apple iTunes | Spotify | Google Podcast | Stitcher | Amazon | Castbox
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Transcript:
[00:00:00] Kym: Hey, everybody. Welcome back to another episode of the Traveling Therapist Podcast. We have a super interesting story to tell you guys today. I'm really excited to invite Karen Ann Schmid here with us. Now, Karen is gonna tell you a little bit about herself, but I just wanna say I've personally been sort of, like, I don't know if we would call it mentoring Karen.
[00:00:19] I don't know what you would call it, but meeting with Karen, talking with Karen a little bit through this journey, so I was excited that she agreed to come on the podcast, 'cause I really want her to share her amazing adventure, but also what she's been struggling with as a traveling therapist right now. So
[00:00:31] Karen, welcome to the podcast. Really excited to have you here. Can you let everybody know, how did you go from being a typical therapist to a traveling therapist?
[00:00:41] Karen: Well, good morning to you.
[00:00:43] and thank you for having me. I actually came out of retirement because I needed a little extra dosh to work on a, house actually. Um, my partner and I bought some land here, and I'm-- I might as well tell you right off the top, I'm living on 32 acres of farmland in the northern part of the North Island of New Zealand.
[00:01:04] and I'm a federal retiree. I retired when I was 43. and I ended up retiring on a disability after being through a very toxic work environment. So I didn't really need to work 'cause I was ga- garnering a pension. But when we decided to, to move off... I lived on an island for, for about 19 years off of the coast of Auckland.
[00:01:28] We lived on Waiheke Island, and then we moved here on December the 28th. So I started working, though, in order to make the move about four years ago, and I s- and I fell into platform work. And I started out with the quickest and easiest that I could which was at that time was BetterHelp.
[00:01:47] They got me up and running pretty quick, and they slammed me with referrals 'cause they apparently had r- I mean, they have a massive advertising thing. So they managed to capture me into that. and I thought this is really novel. I like this better. I had, I had been involved with crisis text line for Ireland and that kinda went down in flames.
[00:02:10] So there was just a lot of stuff, but I d- this, this worked out for me. But I ended up going through about-- I've been involved with about four platforms and three of them have gone down in flames eventually after working with them for three years, two years.
[00:02:28] And I've been through BetterHelp. I've been through talk space. I've been through growth therapy, which I liked, but they disqualified me for a contract with them. And I actually have a EAP company which I've gotten absolutely no work in years out of Colorado, which has now changed ownership, and I'm ready to kick them to the curb. So that's how I got here.
[00:02:52] Kym: Well, let's... All right, so let's, let's talk about this because um, you say I retired at 43, but we should tell everybody, I mean, you, this was how many years ago? I mean, you just had a birthday milestone, right?
[00:03:02] Karen: Yeah, I was 43 and I just turned 70
[00:03:05] Kym: Right.
[00:03:06] Karen: last month
[00:03:07] Kym: Yeah, you just turned 70, and, you know, you know, I guess my first question, did you just keep your license active all those years?
[00:03:14] Karen: Yes, I did. Yes,
[00:03:16] Kym: in case? Okay, interesting. Yeah,
[00:03:19] Karen: And that wasn't without a lot of struggle, too, but that, it, but I did it. I did it, you
[00:03:24] Kym: Okay
[00:03:24] Karen: I've had to go through two audits, and it's just, you know, it's been really hard because that's one thing that I can say about practice overseas, is that the definition of a clinical social worker is not the same from country to country.
[00:03:41] This country doesn't understand that, we're trained as independent practitioners you know, as a mental health practitioner therapist in, in the U.S. 'Cause here you, you get a social work degree, you're gonna be, you know, a family social worker, you're gonna be a this or a that, but they're, they don't give you the independence nor the salary.
[00:04:04] It's just a real different... You're talking real different definitions of what a clinical therapist is, so
[00:04:10] Kym: Okay, so you moved to Auckland, what'd you say, 17 years ago? 18 and a half years ago?
[00:04:15] Karen: I came here September 1st of, 2006.
[00:04:19] Kym: Okay. Wow
[00:04:20] Karen: I'm gonna have my 20th anniversary out of country in another couple months
[00:04:25] Kym: That's amazing. so you did that, but all along you're like, "Well, what if I do need to use my license at some point?" Because you're over in this o- other country, you're realizing, like, okay, they're not even recognizing a psychotherapy license. So, if I ever need to go back and work for some reason, I'm just gonna keep it, or you just thought, I love the fact that I have this thing and I just wanna make sure I keep it. Like, what was the thought process for you around
[00:04:47] Karen: initially I thought, you know, I worked really hard for this license and I'd be darned if I wanna let it go, you know, just like that because I don't wanna take the time to keep it. And plus, you know, when I came here, I had kept my house in Baltimore. And, you know, coming here to live with my partner was the noble experiment.
[00:05:06] I didn't know if the relationship was gonna work or not, and I was very reluctant to let go of, things that... I'm sort of a survivor kind of person, so you know, you don't burn your bridges so quickly.
[00:05:20] Kym: for a little background for you guys, like she's in the Traveling Therapist Facebook group. She's reached out to me. We've chit-chatted, you know, privately 'cause she's had questions and problems coming up that we're gonna talk about. But wasn't there a story about your partner? I can't remember. I feel like you said that, like, was your partner already over in New Zealand
[00:05:38] Karen: My partner was in New Zealand
[00:05:40] Kym: Okay,
[00:05:41] Karen: when I was working for the government, I had a visitor to the hospital where I worked. I worked for the VA. I worked for the federal government.
[00:05:47] Kym: Yeah.
[00:05:48] Wow.
[00:05:48] Karen: Anyway, ran into the driver's side of my door of my car, and I developed fibromyalgia, which I still have. I have a chronic pain disorder. And I had a toxic managerial change. So what happened was I was being treated for the fibromyalgia, and so I went into a very early, chat room in TalkCity. Those of you that are older than, dirt like me will may remember it. But anyway, I went into an alternative health room to see what they were injecting me with, which was something called prolotherapy.
[00:06:20] And I didn't know what it was, and I just happened to run into who was gonna be my, my wife in, in that chat room, in that space doing this. And so that's, that's how it happened. I mean, you know, so technology was working on my side along with the cosmos, so that's how it happened
[00:06:42] Kym: And so then you're like, "Okay, I'm gonna, I'm gonna leave. I'm gonna relocate to this other country." But
[00:06:47] Karen: cross my fingers, but
[00:06:49] Kym: Yeah, cross my fingers.
[00:06:50] Karen: I'm gonna hold onto my house. I'm gonna hold onto my bank accounts. I'm gonna have my cell phone, US phone number and so
[00:06:59] Kym: lot of people ask that, like, "What do you do? Do you cut all ties? Do you, you know, do you have to keep residency in the United States?" But you kept all of that, so I'm wondering, like, over time have you slowly let go of that stuff, or do you... Are you still maintaining a presence in the US?
[00:07:13] Just for people listening that might be like, "How are you doing it long term?" Yeah
[00:07:18] Karen: Well, you know, my wife would tell you that I don't let go of anything. And and so, you know, I've got three containers of things I brought from the US. I had older... I had aging parents. My mother had Alzheimer's disease, and my dad... My mom died at 88, and I, you know, and I tried to do long-distance caregiving with, and coaching with my father who w- who was, you know, he died at 93, 93.
[00:07:45] And I just wanted to make sure that I did what I felt comfortable doing so that when in, when it ended, I wasn't gonna say, "If I had only something," you know? So anyway nonetheless I d- I just, I didn't, I don't like letting go of stuff. But anyway, Eventually, I, I realized that I could... You know, I, I also felt, I also experienced some xenophobia when I came here, which is important, I think, to people that do leave country especially now, 'cause there's a...
[00:08:18] I have a lot of clients, or I have had a lot of clients that are, that are really, you know, suffering with the anxiety of the political milieu there in the US. So, nonetheless there's, there's sort of two schools of thought about Americans here in New Zealand. Some love us 'cause they glad that we didn't, you know, desert them in World War II and make them speak Japanese, and then there's the other part that hate us because of the Rainbow Warrior and the anti-nuke movements c- sort of very strong here.
[00:08:52] And, and they also have a very strong feeling about people that appear to put thems- stand out. They call it a tall poppy syndrome, and so they don't, they don't respond very well to people that, that, that maybe strive for excellence, you know. That it, it could be really difficult. And, and I also decided to try to r- to get my credentials, which I had in the US verified here in, in New Zealand and, and get working with them in a regular kinda nine-to-five job situa-
[00:09:29] And, and I got a whole lot of pushback, and so I ended up doing things like, you know, cleaning the police station selling used clothes. And one of the things I've always said about being here is that oftentimes you have to do several things just to get along, get, get, get, you know, get, get by. My wife continued to work.
[00:09:52] She worked for the university, Auckland University and was a wa- science instructor.
[00:09:58] Kym: Wow,
[00:09:59] interesting
[00:10:00] Karen: And we've lived in a vineyard and some other things, so.
[00:10:04] Kym: Wow.
[00:10:04] Karen: anyway, so I... That's how that kinda... So those things didn't work for me, you know, in terms of qual- qualifying. I'm still waiting right now. I paid my $600 to...
[00:10:16] It's gone through three different changes of, of names, but it's now the New Zealand Social Work Board. And, and they have not... And they, and they gave me a letter saying that my credentials were ver- w- I'm eligible for registration, as they call it. They don't license. And and they... It's been... It'll be a year in July that they've had my money, and they haven't proceeded to, to register me.
[00:10:42] Their excuse is that I don't have a job offer, but how can I get a job offer for myself, you know? So anyway
[00:10:51] Kym: would you, where would you work if, if it came through? If, are there places? I mean,
[00:10:56] Karen: Actually, I don't think I would work anywhere right now because it's, the, the salaries are pathetic. And so even the even the pathetic salaries from the pathetic platforms, which we will remain nameless,
[00:11:09] Kym: Yeah.
[00:11:11] Karen: you know, in the exchange rate, I ended up doing much better, you know, making my pittance, you know, overseas.
[00:11:20] And so... And I d- like I said, I kept the bank, I kept the, the, the, the phone number. I have an old pay-as-you-go kinda T-Mobile line. I don't answer it. I don't use it. And nowadays I get to have two SIM cards in my phone. I have my SIM card for my, for my T-Mobile account, and I have a, a local a local phone company here in New Zealand, and I have a, an E slot too that I haven't even used, so
[00:11:48] Kym: Yeah, that's the thing now, right? The eSIMs, so you don't have to
[00:11:50] Karen: And I guess I'm-- 'cause that's probably a the easiest thing to say right off the top. I am not technology-oriented, and, and it changes so fast that even when I struggle to get an understanding of what it is I need to do, I have a proxy account. I have all kinds of things that people that want to try to do this thing that I'm trying to do have to be kinda clued in on, you know, which is the bank accounts, the telephone numbers, the, the virtual addresses, the, you know, the proxy accounts to get into Captcha.
[00:12:27] You know, there's just a-- I mean, it's been a step-by-step learning process where I've had to figure things out, and I've been figuring it out majoritively on my own, as you might have noticed
[00:12:38] Kym: You have, yeah. I mean, I mean, you reached out to me when it got bad, but it's like I know you've been... I mean, well, you've been over there this long, and then coming out of retirement, and then it's like, okay, now I actually... how do I put all these pieces together after just trying to be like a US, like, have a, I guess a US presence, and then now living over there for that long and figuring all that out.
[00:12:58] And then, then figuring out the licensure and the working and all of that stuff, so. Okay. So yeah, I mean, that's how I think most of us do it. I mean, we, we do have the Traveling Therapists Facebook group, thank goodness, 'cause I mean, every day there's, like, somebody posting with a problem similar to yours, and thankfully there's people like you and other people that have figured it out already, you know?
[00:13:19] So thank goodness we have that. But yeah. What were you gonna say after that?
[00:13:22] Karen: if nothing else, the support or the, or the understanding you're not alone or that you have a community is real important
[00:13:30] Kym: It really is. So let's tell everybody, 'cause I mean, you're... I, I've cited your case quite a few times lately when other people have reached out to me about like, "Can I work for so and so? Can I do this? Can I do that? They're telling me I can. They're telling me I can't." Let's talk about what happened to you.
[00:13:46] So you j- you decide you're gonna come out of retirement. BetterHelp pops up. You know, everybody gets... I'll probably get
[00:13:51] Karen: They recruited me
[00:13:53] Kym: They recruited you,
[00:13:55] Karen: Three times
[00:13:56] Kym: and you told them where you were located, right? I mean, you have the US presence with the business address or whatever,
[00:14:02] Karen: Yes
[00:14:03] Kym: but c- could you, could you explain the story?
[00:14:06] Because every day, I feel like I'm seeing this now in the Facebook group where somebody will say, "Well, I'm just gonna work for, you know, Headway," you know? And it's like you can't, you can't do it. You can't do it. But even the companies give the wrong information. So maybe
[00:14:21] Karen: That's right
[00:14:22] Kym: the BetterHelp thing a little bit?
[00:14:24] What
[00:14:24] happened?
[00:14:25] Karen: recruited me from off of a LinkedIn page, I think.
[00:14:30] Kym: Yeah, they're all over
[00:14:31] Karen: I can't re- I can't remember that far back now. But anyway and I, and I always I always told them where I was located.
[00:14:40] Kym: Yeah.
[00:14:41] Karen: And I, and I never told them that I was just visiting or any of that either. You know, I n- I never wanted to tell a falsehood.
[00:14:51] I think that's just bad business. It's, it's just, it's gonna ... You're gonna get caught getting over that fence. So, I said, "Well, if you can handle the fact that I, you know, I'm, I'm overseas and that, you know, I do have a US bank account and I do have, you know, I can be contacted on a US phone number if I have to be.
[00:15:12] But, you know, whatever." And they said, "Oh, that should be no problem." And the recruiters don't talk to the policymakers. I mean, they're probably hired from an employment agency to just recruit. That's what they do. And then there's very little communication. So BetterHelp went through that process with me, as did Grow Therapy, who had hired recruiters again.
[00:15:37] I was so happy to go to Grow because of the salary nonsense with BetterHelp
[00:15:43] Kym: I mean, we all know, and if you don't know and you're listening, I mean, Better H- Help is abysmal. I mean, they, they slam you with, like, 50 clients a week. Th- they're, they expect you to answer at all hours is my understanding. Correct me, Karen, if I'm wrong. And, and I think pay comes out to about $30 an hour after all of that really intense
[00:16:01] Karen: Right. Well, they've kinda done some stuff to zhuzh it up a bit. They... You- what happens is you, you open for referral, you set up a calendar on the platform, they send you referrals, you say yes or no. You spend a lot of time answering referrals, reading them, trying to give a personalized response and, you know, that's that's a really difficult situation.
[00:16:23] I'm really happy to, to invite you to join with me and, and schedule a session so we can talk about how we might work together, blah, blah, blah, blah. Standard issue kinda stuff. And and they show up and then, And that was a membership originally. It was a membership. You paid... It w- at time I, the last time I looked it was something like $240 that you pay as a membership for four sessions a month or something like that.
[00:16:51] And then the... And they had a, a gradient in terms of how they paid the, the provider. So the first five hours you got I think you got $35 a session
[00:17:04] Kym: Oh my God.
[00:17:06] Karen: It wasn't even about time. It was a session, $35 a session. And the expectation was it was a 45-minute session. I always run hour sessions 'cause they're just... I...
[00:17:17] 35 minutes, 30 minutes is not enough for me, and 45 is, is barely getting it done. So it just isn't what I... my style. So then the next five hours you get paid you get paid $40, and then the next five you get
[00:17:34] Kym: So it's like incentivized to cram more people in kind of thing.
[00:17:38] Karen: And full-time is 30 hours a week. Now, what they have done is BetterHelp has gone to a to an insurance basis, and I can't tell you for sure who they have handling their insurance claims.
[00:17:52] Kym: Mm-hmm. Mm-hmm.
[00:17:54] Karen: And that raised it up about Maybe it started out at 45.
[00:18:02] Kym: Geez.
[00:18:03] Karen: when you realize that they're probably raking, when they're raking in a hundred and some dollars, you know, and you're getting, and you're getting 45 tops. I mean, and they also used to pay by the word if you did a synchronous messaging. And, and then they also had just a you have, you know, you have the audio chat versus the, the, the, the, the the video stuff.
[00:18:31] And I never liked those
[00:18:33] Kym: So I know, I don't like those much either. So, okay, so how many years ago was that where you were like, "Okay, I'm gonna come out of retirement. Oh, here's BetterHelp. Cool. They don't pay
[00:18:42] Karen: In October it would've been four years,
[00:18:44] Kym: Okay.
[00:18:45] Karen: and they kicked me to the curb probably about maybe six months ago
[00:18:51] Kym: So tell everybody how that happened because this, this is when I first met you, I think, when you reached out to me and you said, "Look at this, look at this letter I got." Or maybe you had reached out to me earlier. No, it was BetterHelp first and then Grow went and did it later. But,
[00:19:05] Karen: Mm.
[00:19:05] Kym: Could you tell
[00:19:05] us
[00:19:06] Karen: I kept, I kept-- when I moved from, from from BetterHelp to to Talkspace and moved to, from Talkspace, 'cause they kicked me to the curb, too, I moved to Grow. But I kept the BetterHelp thing because they hadn't decided to kick me to the curb, and I j- and I-- so I used it as a fallback, you know, when, when Talkspace went down to just keep working, and then I got hooked up with Grow, and they took over.
[00:19:34] And so I only had one client that I kept on BetterHelp, but I just kept it going and made myself unavailable until I l- I lost my work contract with, with, with Grow. So, so what happened was I went into, So BetterHelp was still always there throughout the years because I wasn't really active and they-- I was below the radar, I guess, or something.
[00:19:57] I don't know.
[00:19:57] Kym: Yeah
[00:19:58] Karen: So when I went to Talkspace, I went to a, a CEU conference and they realized that I was-- one of the trainers realized I was out of country, and they blew the whistle on me with their ethics policy-making people, and they sent me out a, a kind of a warning shot saying, "We're gonna have to look at this."
[00:20:22] And I said, "Well, you didn't look at it when I told it to you straight up, so w-what's this about?" And so, and I said, "And this is really this is really disruptive for clients. It's not just about me. You know, I mean, yes, it's about me, but, you know, this is not a good way to treat your clients without notice."
[00:20:41] And they literally just turned me off.
[00:20:43] Kym: Yeah. Wow.
[00:20:45] Karen: before they turned me off, I went ahead and took names and addresses, you know, 'cause there was nothing saying that, you know, I couldn't invite them to follow me wherever I went. And so when I st- when I started hearing rumblings about it, I, I let-- I've always been very good about keeping clients
[00:21:07] Kym: Mm-hmm
[00:21:07] Karen: in the loop about what was happening,
[00:21:10] Kym: Yeah.
[00:21:10] Karen: because they really didn't take a lot of notice of clients and continuity,
[00:21:17] Kym: Mm-hmm.
[00:21:17] Karen: know.
[00:21:17] I thought, you know... So anyway, then I went to Grow after I got kicked to the curb with Talkspace from that training thing where the trainer ratted me out, so to speak.
[00:21:30] Kym: Yeah, and when you say kicked to the curb, I mean, basically they're saying you're not allowed to be located out of the United States, even though you've disclosed this and all that. Yeah, so they're like, "Sorry, nevermind, you can't do
[00:21:39] Karen: That's right.
[00:21:40] Kym: Mm-hmm.
[00:21:41] Karen: Mm-hmm
[00:21:42] Kym: So then you went to Grow, which at the time they didn't have a policy on this, right?
[00:21:46] 'Cause I, I know this is a more recent thing with
[00:21:48] Karen: I don't think they te- I don't think they thought about it, because I don't think they anticipated anybody trying to make it work,
[00:21:55] Kym: Mm-hmm.
[00:21:56] Karen: you know? But they, but I had a, again, a person that onboarded me, walked me through how to get on the platform, how to use it, and we had a video, this and that. And, you know, and they were all very animated and very excited about that I was doing this and how novel and all that nonsense.
[00:22:14] And then all of a sudden I got a message saying you know, I guess probably that's been a... Maybe that was a, a year ago. I can't even remember. It c- your time just gets really collapsed. But they basically said "If you-- Please confirm that you are practicing from within the US."
[00:22:35] Kym: Wow
[00:22:36] Karen: "Well, I can confirm I'm not practicing within the US.
[00:22:39] I never have been. You've always known that."
[00:22:42] Kym: Yeah
[00:22:43] Karen: And so then I got a note that said, "Cease and desist
[00:22:48] Kym: Jeez
[00:22:50] Karen: And,
[00:22:51] Kym: wow
[00:22:52] Karen: And so I w- rapidly composed a note to all my clients to say what was going on and that it looked like I was gonna be cut off. They were g- not gonna be able to, to stay with me on Grow, and if they wanted... And I c- and they, they told me to, you know, that I... They gave me some kind of cut me some slack in saying that if I had some extreme cases that I needed to continue to see off of, of, of Grow, I could do that.
[00:23:22] So I just took that literally and just sent everybody a note and said where I'm going, you know? And at that time I said I'm gonna retreat to, to BetterHelp until I can get situated again. And then and then the, the, the, they, they hadn't-- they didn't have an insurance part then. They were still the membership thing, and people with insurance didn't wanna be paying 240 or 260 a membership a month.
[00:23:51] It's a subscription plans.
[00:23:53] Kym: Right, right. Well, if they could use their insurance, right.
[00:23:56] Karen: Yeah. So anyway, they they ended up, So I, when I ended with them I had, I had already poached my email addresses and everybody knew where I was going. And then I, and I said that I was gonna work on going private 'cause three strikes and I'm done,
[00:24:15] Kym: Yeah.
[00:24:17] Karen: you know? So I said I'm gonna kick this effort of mine into a higher gear to get...
[00:24:23] You know, if I can do it privately, I'm gonna do it, you know? W- and I'm gonna do it, and I had to do it as cheaply as possible.
[00:24:32] Kym: Right.
[00:24:33] Karen: I had to, I had to try not to fall into any rabbit holes where I'm paying money for something I don't need or I'm... You know? So it's but I didn't want it to not be, Not only did I not want it to be expensive, I didn't want it to be not good enough.
[00:24:51] Kym: Yeah. Right. Right
[00:24:53] Karen: So I said I, you know, and so it's this sort of if you want something done you ha- well, you need to do it yourself. And so I did that the best I could, but then I tripped on you and Portable Practice and some other things, and I was starting to get the feeling that there were, there were some people that knew more about what I was trying to do than, than I did.
[00:25:15] And, you know, and when I hit a wall, you know, I'd... Sometimes I'd spend days f- kinda swimming through the, through the systems and whatever. So,
[00:25:28] Kym: crazy. It's really exhausting. It really is, trying to
[00:25:31] Karen: Yeah. So I mean, I, you know, by the time I got to you, I had already done a lot of stuff, as you might have remembered, you know? And but a- again, the, the trick is being able to coordinate those moving parts, as I call them, you know?
[00:25:49] And I haven't been able to quite succeed and get over the line with that yet
[00:25:56] Kym: Yeah, we're, we're working on it.
[00:25:58] Karen: Yeah
[00:25:59] Kym: after talking to Karen, I mean, and for people listening, this is just for people listening you know, this comes up every day in the Traveling Therapist Facebook group, the insurance piece. And that's the reason why most of the platforms are now saying you can't be out of the country, 'cause most of them didn't care.
[00:26:13] Even Alma, that actually sponsors this podcast, didn't care until September of 2025. They, they actually, like, supported the traveling therapist lifestyle. They're like, "Yes, we wanna sponsor your podcast. We're so excited to, to, to, you know, you know, fund these or help with these alternative lifestyles." And then even for me, I'm like in with the people there.
[00:26:35] W- With me, they send me an email one day and they're like hey, ugh, hate to do this, but we have to change our policy." And I'm like, "Are you ki- are you kidding?" Like, I mean, I, like, promote this to the traveling therapist constantly as, like, a really good way to
[00:26:49] Karen: in the US, you're okay
[00:26:51] Kym: Exactly. If you travel in the US, you're okay.
[00:26:53] But I love Alma still. I'm not bashing Alma or anything. I'm just saying, like, all of them changed their policies because they are insurance-based, and most of the insurance companies are okay with it, but Blue Cross Blue Shield is not okay with it. And you know, some of the smaller state-specific insurance companies aren't okay.
[00:27:14] Some of the Medicaids aren't okay. Medicare's not okay. So when you start looking at all that, if you're, if, you know, if you, if you're eligible for Medicare, you have to be eligible M- for Medicare for some of these commercial plans because they do Medicare HMOs. So if you're not eligible for Medicare, you can't even be on the commercial credentialing, and it's
[00:27:32] Karen: I know
[00:27:33] Kym: maze of just insanity.
[00:27:36] You know? It's just
[00:27:36] Karen: Yeah, and I know they would con- they, all these pl- yeah, all these platforms would contact me, say, "Do you wanna do Medicare or Medicaid?" And I said, "I can't."
[00:27:45] Kym: Yeah, leave me alone.
[00:27:46] Karen: And they said, "Okay, why, why can't you?" And I'd tell them, and then they'd say, "Okay." And then we'd just go on like usual. And then then months later they'd come back to me and say,
[00:27:55] Kym: Yeah.
[00:27:56] Karen: "See ya."
[00:27:57] Kym: So, so Karen reach, reaches out to me with this stuff 'cause I'm the admin of the Traveling Therapist Group, and she's like, "Look, look what's happening." She's sending me stuff, and I'm like, "Oh my gosh." So I meet with Karen and you know, it's like the plan, right? K- Karen's plan was like, "Okay, I guess I should just try to get independently credentialed and do the insurance on my own."
[00:28:15] And you know, my advice to her and to everybody is probably shouldn't do it, do that. I mean, I'm not the end-all be-all of like decision-making for people, but, but I... The writing's on the wall, and it's just slowly over the years I've just seen that option become less and less and less an option.
[00:28:33] So you know, Karen decides, "Okay, well, I think that's a good i- I think I won't credential"
[00:28:38] Karen: was a real big revelation to me to say, "No, you don't have to, to credential and wait for them to open their panels, and you don't have to go through 180 days of them figuring it out and saying no in the end anyway." So, you know, you can, you can go on without, without, you know, without having to get credentialed on these individual insurance panels as pr- a provider, and that you can do the out-of-net, and that just...
[00:29:05] That was just, that was the biggest, that was the biggest revelation that I got from you 'cause like I said, I had done a lot of other kinda stuff to kinda CYA
[00:29:15] Kym: yeah,
[00:29:15] yeah
[00:29:16] Karen: the address in Delaware with virtual this and that and bank accounts and, and
[00:29:23] Kym: Yeah
[00:29:23] Karen: so... But I haven't been able to quite get across the line with my billing yet
[00:29:28] Kym: We need to f- we're gonna figure that piece out. So I did tell Karen about, you guys probably know Mintaya. Thrizer's another one. And you did... talked to Mintaya, Karen talked to Mintaya, and as of our recent conversations, it was okay for the provider to be located wherever they wanna be located and submit, let Mintaya submit super bills on the client's behalf.
[00:29:49] So that is sort of where this trajectory's taken us, and Karen's now reaching out to these clients, as she was smart enough... If you guys are listening to this, and you're smart enough to get names and numbers of clients off your, like, existing platforms, if you ever decide to go international, as, as I know right now, it's not like a c- a non-compete clause.
[00:30:10] Like, they don't say you can't take your clients with you,
[00:30:13] Karen: Yeah, there's... I haven't seen anything that's really s- logistically told me I can't poach people.
[00:30:19] Kym: Yeah.
[00:30:19] Karen: But I don't really poach people because if y- you, you saw what I sent out in terms of a letter of just a sort of a newsletter kinda thing and saying, "Okay, you know, I'm done. You know, w- we've... I told you that I was gonna work on some things and see if I could find a place for you to land.
[00:30:36] If you wanna land with me, that's fine, but if you've moved on and you've got a- another person that's working well for you, I'm happy for you," you know? I've never been a hardcore seller person.
[00:30:47] Kym: Yeah
[00:30:47] Karen: you know, so and now, so now that I've, that I, that I've sort of done that, that, you know, try to bring over the ones I can bring over or who want to stay, which, you know, I'm not really sure.
[00:31:01] Some of, some of these people took an opportunity to just take a break and have just decided to s- to stay on a break, and that's okay.
[00:31:07] Kym: sure. But at least they, the, the seed has been planted, you know? When they're like, "Oh gosh, I've got this going on. Let me reach out to Karen.
[00:31:14] Karen: But I have started to use, as you know, I've started to use-- I mean, I've, I love, I mean, I, I've, I don't l- I do all my ChatGPT stuff on this 'cause I don't want it to get ahold of my information on the laptop and I, I don't wanna mix, I don't wanna mix that up yet. I'm still cautious about AI and, and what it can do.
[00:31:37] So anyway but I have used it and I love gen- these huge rock questions I ask ChatGPT, you know. You know, is God so big and powerful he can make a rock so heavy even he can't lift it kinda question.
[00:31:52] Kym: I love that
[00:31:53] Karen: where I just sorta say, "Okay, I wanna know, you know, what are the..." An example right now is what are the organizations that will, that service my population of cho- my populations of choice?
[00:32:08] And, you know, and the, they have to be in Maryland and, and DC area. And I need email addresses and contact numbers, and I need a letter that, of introduction, and I need a letter of service, you know, that's tailored for each of these populations. 'Cause I have about maybe four or five, I don't even know, four or five niche populations.
[00:32:32] Plus I've started to do some, you know, I've done some Udemy stuff to kinda give myself another option, which is the coaching option, which, you know, we've talked about briefly. But, you know, right now I'm still trying to get the clinical option straight. 'Cause I mean, it's either a step up or a step down when, when you do life coaching, you know.
[00:32:54] In other words, you don't need the clinical services as much as you need the organizational and the supportive services that come through coaching that are tailored. But anyway, so and so basically my next port of call will be to send out letters of introduction for my services and, and I did, and I developed, I used Webicor
[00:33:17] Kym: Mm-hmm.
[00:33:18] Karen: to develop my, my website, which actually I'm, I'm, I'm pretty happy with it.
[00:33:24] Kym: you did great with your website.
[00:33:26] Karen: And then I did I also had, I also told ChatGPT that I wanted a logo for my business. My business, my business is called SEEN, which is for Support Empowerment and Enrichment Network Services. And I wanted it to be inclusive.
[00:33:45] I'm, I'm, you know, I ha- I tend to do a lot of women's empowerment stuff.
[00:33:50] Kym: Mm-hmm. Nice
[00:33:51] Karen: I do a lot of LGBTQI+ stuff. I do elder care stuff, life planning, end of life planning. You know, I, I... There's a, there's a couple things I do, and I do well. So, I've tried to diversify. So anyway, I, I told ChatGPT I wanted a, a tree of life with vibrant colored leaves in the form of human beings,
[00:34:21] Kym: I love it. looks so good, you guys. If you go to her website, go check out Karen's website.
[00:34:27] Karen: And I wanted to have the trunk as intertwined hands
[00:34:31] Kym: Yeah,
[00:34:32] Karen: leading to the branches, and the roots going deep into the earth, and it, it came out magic. So I have tried my... those were my initial efforts at using AI
[00:34:46] Kym: Mm-hmm. You're doing great with it too. Yeah. Yeah, what's your website, Karen, again? Just in ca- in case anybody's listening, they're like, "Hey, I'd actually need a therapist that's in, you know, Virginia or, or Maryland and the DC area."
[00:34:59] Karen: I'm gonna have to do this. It's gonna be https://www.seen,
[00:35:11] S-E-E-N, services
[00:35:17] Kym: Yeah
[00:35:18] Karen: usa.com/
[00:35:23] Kym: Love it. Yep, love it.
[00:35:25] Karen: Hopefully that's
[00:35:26] Kym: out Karen. Yeah, yeah. We'll put a- we'll link it down below in the show notes too
[00:35:30] Karen: But I, that's was, that's the shortened version, so
[00:35:35] Kym: We had a discussion. I gave Karen a little feedback. She had a real long URL. I was like, "Let's see if we can shorten it a little bit so people can remember it a little bit better."
[00:35:42] But yeah. Well,
[00:35:44] Karen: But Webcor is good. I've, I, you know, they, they, they have an AI component that just says, "Answer these questions and we'll do the rest." And, and I've been able to edit and stuff. You know, and m- as a sole practitioner, sometimes you get, you get into the plurals that you have to try to ferret them out. But for
[00:36:05] Kym: you're doing it. I mean, and you know, not that 70's old, but to, to be in retirement, to come back and at 70 be like so determined to navigate this stuff and try to figure out a way to still be able to see your clients and, you know, make some extra... Maybe you got the pension, you've got your wife and that income, but still trying to like, just like go through this.
[00:36:26] 'Cause I think a lot of people would've been so frustrated at this point and just been like, you know, "Screw it." But you haven't. I mean, you just keep trying, which I think is amazing.
[00:36:35] Karen: And you do have to... And, and that's the other thing that I think was important about my encounter with you, is to say that what I'm doing, I'm not trying to do something illegal or unethical
[00:36:46] Kym: Oh, thank you for saying that. Yeah, just like
[00:36:48] Karen: That's a really important part.
[00:36:50] Kym: Yeah.
[00:36:52] 'Cause we get
[00:36:52] Karen: that's an important part, you
[00:36:54] Kym: too. Yep, absolutely. We get that in
[00:36:56] Karen: systems would like you to believe you're doing something naughty, and you're not.
[00:37:00] Kym: Yeah
[00:37:01] Karen: And so that, you know, that's a real deterrent I think for, was, w- would be for me is some... If I was doing something or being false about something, that would really upset me. That would not jive with me. But that was another really important thing that people have to remember. But I'm, I'm very, I am a dog with a bone, and I just, I don't let, I don't want things to beat me, and that includes the technology.
[00:37:24] And so much do I curse technology, you know? So, but I'm, I'm still trying to make it work. I'm not giving up yet, but there are days where I just, I just collapse.
[00:37:37] Kym: Yeah, I know
[00:37:39] Karen: I just go in, lay down, and just sleep because I just, I, I had enough, you know. But I spend hours
[00:37:47] Kym: Just good therapists just trying to do good work, and they've gotta
[00:37:50] Karen: Yeah. And I live in a very rural community, which is even another complication that you, you may... People that go overseas with their internet hookups and things like that. I have no phone service, no television service, no, no internet service any number of things, unless I can get them all to work on Starlink
[00:38:14] Kym: Right. Right. Starlink's the only option. Mm-hmm. Wow. It's amazing.
[00:38:18] Karen: anyway, and, and Starlink is somewhat portable, but, you know, nonetheless I, I mean, I, I live-- I mean, I, I-- It's daylight. I'm looking at my farm hills and the cows and, you
[00:38:31] Kym: I've seen
[00:38:31] Karen: I'm,
[00:38:32] Kym: It's beautiful.
[00:38:34] Karen: you know. But and then living on the island was also kind of weird. But yeah, so th-that's sorta, sort of the story. But it, it's, you know...
[00:38:45] And each of us have these crazy stories that are unique to our own journey. You know, I just don't know of too many 70-year-olds that are bothering with this. And I'm not saying that I'm gonna bother with this in a big way, but I swear to God, I'm gonna get through this somehow. And
[00:39:01] Kym: clients, and by God, you're gonna see those clients.
[00:39:05] Karen: I'm gonna make a little money. And, you know, and, and, and that's another thing I might, I might caution people is like, please do not end up owing IRS
[00:39:15] Kym: Yeah. Right, right. We could do, like, a whole episode on that, I'm sure.
[00:39:20] Karen: Yeah. Yeah. I, and I have, I, you know, I, you know, the taxes are so complex.
[00:39:26] Kym: Yeah.
[00:39:28] Karen: And the other thing I might say to you is also, I, I mean, for say to everyone, is to, to, to make sure that your country doesn't have any prohibitions about you working out of country, and that they want to make sure that in y- in their country you're doing work that you, they sanction.
[00:39:47] Because the, some countries don't, don't allow that. But I called, I called the registration people, and I called the ministry of whatever it is here in New Zealand and said, you know, "Do you have any prohibitions about me working offshore, collecting offshore money, paying taxes to that entity?" And I have a tax...
[00:40:07] I'm under tax treaty for my pensions and things. So everybody has their own unique thing, but as a federal government person, I have a little bit of benefit, and as long as I'm paying my taxes in the US or at least responsible for it anyway and dealing with them, I am, I'm covered here. I don't have to pay double taxation.
[00:40:29] But it, you, you gotta know what your own, your own jurisdiction, you know, requires, you know. But again, like I said in the beginning, you got to understand that, that different countries have different ideas about what a clinical professional is, you know. Because I mean, finding work here for me was just a bloody nightmare, you know.
[00:40:53] I mean, and so, like, I just did what I had to do. I mean, you know, I made muffins for the Saturday market. I mean, we just have done a lot of... We made vinegar. We grew mushrooms. I mean, we've, we've done a lot of things, you know, just to, you know, get by. But my wife is, actually came here when she was 12 from the UK, and we're both, you know, we're both survivors.
[00:41:17] I mean, we both didn't grow up... We didn't come up easy. Let's put it that way. You know, so, you know, we have a little bit of backbone. But,
[00:41:27] Kym: Oh, I'd
[00:41:28] say.
[00:41:29] Karen: you
[00:41:29] Kym: You're really tough and you're really trying to figure this out, so I admire you for that. And I just wanna say thanks for coming today, being a guest. I
[00:41:37] think
[00:41:37] Karen: thanks for having me. I ho- I hope it helps. I
[00:41:40] Kym: Yeah, I think it
[00:41:41] Karen: that was the one reason I said, "How can I help?" I mean, if I can, I want to, but, you know, it's, it's, it's not a very straightforward simple process, and it probably isn't for the faint-hearted either
[00:41:55] Kym: probably not. Yeah, agree with that. Well, on that note, I'll wrap it up. You guys, we'll put Karen's beautiful new website in the show notes so you guys can check it out.
[00:42:05] Karen: Share it around, pals.
[00:42:06] Kym: it around please. Get Karen some, some private pay clients or out-of-network clients that she can see. Karen, thanks so much for being here.