How to Start a Private Telepractice: Systems, Clients, & Contracts

I'm thrilled to welcome Ellie Richter, a bilingual speech-language pathologist with nearly 15 years of experience in teletherapy and traditional speech therapy settings. Ellie is here today to share her experiences and insights related to starting a private telepractice.

Why Private Telepractice is Worth It (For Me)

I tell everyone who will listen how much working remotely has changed my life. I know not everyone wants to work from home, but the benefits of telepractice have been transformative for me, my family, and my career.

Like most SLPs, I fell into telepractice in 2020, piecing together training from internet deep-dives and support from coworkers who were doing the same. We compared notes and resources and figured it out by trial and error.

When it came time for me to make a career change in 2022, I decided I wanted to work for myself and go all virtual.

This blog is an overview of my journey creating a virtual private practice. Please know this isn’t advice, but sharing what I did for myself. I recommend speaking with a small business lawyer and a CPA when it comes to financial and legal decisions.

Much of the basic “start your own business” information is already available, and there are experts who are ready to help with those steps, so I’m going to focus on the steps I took AFTER I started my practice and focus on the specifics of VIRTUAL practice.

Licensure

If you’re ready to work remotely and wondering what you need to do, you’ll need to start with your licensure. A good rule of thumb is to hold licensure in the state where you reside and the state where you work. Each state has different requirements, and you'll want to check and see if your state is participating in the ASLP-IC, the Interstate Compact license. This is going to be a huge asset to virtual SLPs!

Mentorship

Mentorship absolutely matters because you’re going to have questions. When I got started, I got support from both Jena and Elise for starting up my private practice and starting up my school contracting, respectively. I still get support from both of them!

Systems

Working remotely is similar to working in person in that you’ll need systems in place, including your video platform and your billing/invoicing. You’ll need to make sure your programs are HIPAA and PHI compliant.

All-in-one systems:

I have lots of colleagues who use SimplePractice, Fusion, and TheraPlatform.

Lightweight systems:

I personally use Google Workspace (HIPAA-compliant setup) and IvyPay. Specifically, I use IvyPay for my private clients, and I send monthly invoices for school contracts. My best advice regarding systems is to choose secure, easy-to-use tools that make you feel confident and are simple enough to do over and over again without becoming overwhelming. Don’t overcomplicate this. What works for one person may not work for another.

Services & Rates

When I started my virtual practice, I sat down and wrote out what I wanted my life to look like workwise— the days and hours I wanted to work, the types of speech therapy I wanted to do, and the ages I wanted to work with. Then I figured out how much money I needed to take home annually/monthly to make our bills and lifestyle work. This was quick, but then getting into the deep details took a long time, and there were many Google Sheet drafts. I swear by creating a “Dream Budget” and “Dream Lifestyle” and figuring out how your business can support and create those.

When I figured out what I needed my take-home pay to be, I determined my rates and hours and started filling my schedule. I’ve done it all and pivoted along the way to make sure everything remains aligned.

I have a beautiful combination of: In-person private clients, Virtual school contracts, Virtual private clients, and in-person, on-demand school contracts. I chose to focus my niche on virtual bilingual speech therapy and evaluations. Choose the work you want to do and that work should light you up!

When you set your rates, you need to understand your own personal finances as well as the full array of business expenses you’ll have. Include taxes, prep/admin time and skill set, your insurance, your memberships, your retirement, health insurance, etc. This is where working with tax experts and accountants is very helpful.

Virtual Clients

This is my most asked question: how do you find virtual clients? My advice is to start with what you have, and that’s your relationships. Word of mouth works, especially with a niche. I can’t recommend this enough when it comes to marketing your services: start with your existing relationships. My very first client through my private practice was a school district near me that needed on-demand bilingual speech/language evals. This referral came from my son’s preschool teacher! It has since grown into a 3-year contract.

I personally tend to keep my private client side of my business smaller so I can focus on school contracts. I find that I prefer the financial stability of school contract payments. When it comes to school contracts, I lean into my relationships and word of mouth as well. All of my current school contracts were made through word-of-mouth referrals. However, I did have a school contract last year that I obtained by emailing districts that had open SLP positions posted. You can do that too!

Final Thoughts

If you’re ready to go virtual, do it! Start with a couple of clients and get your footing. You don’t need to burn out to build something beautiful for yourself. You have permission to change your mind, try something new, and pivot or incorporate teletherapy just a little bit in your private practice! If it works for you, you can grow that side of your private practice, and if you’re all in, you can go all virtual! It’s okay to go slow, and pivoting is part of the process.

Surround yourself with support. There are days when the only thing that keeps me going is my network of friends who are working through similar things. We Facetime, Marco Polo, and text throughout the day. You’re not alone in figuring this out.

Want support?

I created The Essential Teletherapist course and consult-coaching to walk you through every step. Learn more or join here: www.theessentialteletherapist.com

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