Episode 17: Not All Who Wander Are Lost — Becoming A Digital Nomad [Featuring Kym Tolson]

Show Notes

During this episode of the All Things Private Practice Podcast, I speak with Kym Tolson, owner of the Traveling Therapist and Insurance Billing For Telehealth Professionals.

Travel and entrepreneurship often go hand-in-hand. Most of us start our own businesses to have more free time, flexibility, autonomy, and the ability to work from "anywhere."

I love traveling, and it's a major reason that I decided that small business ownership was for me.

Kym and I talk about:

• How to start traveling more while maintaining your business
• How I take 12-16 weeks off/year
• Kym's journey into becoming a digital nomad
• Billing insurance and requirements for out of state practice

Meet Kym Tolson, LCSW, CSAC:

I'm a traveling therapist, working on living all throughout the country and working remotely. First stop: Hollywood, Florida, right outside Miami. Then COVID hit. Ugh. Everything shut down. We couldn't travel. Dreams on hold! Luckily, Miami is a pretty great place to be stuck during a pandemic.

During the COVID lockdowns, I had a lot of time to work on my side-hustle, helping therapists learn how to bill insurance in their private practices.

I still saw my clients, but I also continued to perfect my course, "DIY Insurance Billing for Private Practice."

I also created a supportive membership, Bill Like A Boss, for therapists who are billing insurance in their private practices.

Also, check out The Traveling Therapist Course.

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A Thanks to Our Sponsor!

I would also like to thank Embark EMR for sponsoring this episode.

Embark EMR is a superb software solution for solo practitioners, as well as group practices. Embark was designed by therapists to be simple and intuitive without all the extra stuff that you don't need so you don't feel like you're being nickel and dimed. Embark enables scheduling with automatic appointment reminders, a note organization system with multiple pre-built templates, and an automated invoice and superbill generation to make it easier on your clients.

There's even a patient portal where your clients can access notes, documents, and generate their own invoices and superbills. Embark EMR is setting a new precedent in EMR functionality and affordability. Embark’s simple one-tier system is $20 a month per therapist, and there are never any extra fees. Try Embark EMR today with a free trial at embarkemr.com.

You can also use code ATPP at checkout for 20% off an entire year of Embark.

Transcript

Patrick Casale: This episode of the All Things Private Practice Podcast is brought to you by Embark EMR. Embark is a superb software solution for the solo practitioner as well as group practices. Embark was designed by a therapist to be simple and intuitive without all the extra stuff that you don't need, so you don't feel like you're being nickel and dimed. Embark enables scheduling with automatic appointment reminders, a note organization system with multiple pre-built templates, and an automated invoice, and super bill generation to make it easier on your clients. There's even a patient portal where your clients can access notes, documents and generate their own invoices and super bills. Embark EMR is setting a new precedent in EMR functionality and affordability. Embark’s simple one-tier system is $20 a month per therapist, and there are never any extra fees. Try Embark EMR today with a free trial at embarkemr.com. You can also use code ATPP for 20% off an entire year of Embark. 

Hey, everyone. You're listening to the All Things Private Practice podcast, I’m your host Patrick Casale, Licensed Clinical Mental Health Counselor and addiction specialist and private practice coach and strategist here in Asheville, North Carolina. Talking about real issues in small business ownership, becoming an entrepreneur and really trying to normalize struggles, failures and triumphs.

I am here joined today by a friend, Kym Tolsan. She is an LCSW and a CS… CSAC, Certified Substance Abuse Counselor. Again, another conversation about how none of these license types are the same throughout our country and our system making it really challenging. Kym I'm really happy to have you on and thanks for being here. 

Kym Tolson: Thank you! Thank you so much. I'm so glad to be here. Yeah, like you said: the licenses don't even matter, especially for people like us that are now trying to get out of the direct care world and kind of scale up our practices. 

Patrick Casale: It's hard, you know, and I have different guests on here and they're in different states and they have different license names and they all do the same things and it's just confusing.

Kym Tolson: People will message me and say, “Hey, can a LMSW be credentialed with Aetna in this state?” And I'll be like, “I honestly have no clue.” 

Patrick Casale: Right? Yep. I'd get the same thing with, like, people asking me, “Hey, if I, if I take your practice building course, I'm in Arkansas. My license type is this, can I go into private practice?”

And I'm like, “I have no idea. Ask your board and we can go from there.” Um, the conversation that Kym and I are going to have today is Kym is basically scaling up her businesses from private practice and trying to become more of a digital nomad, being able to have alternative streams of revenue, and being on the go all the time.

And if you all have listened to me in the past, you know I take 12 weeks of vacation off a year, but I think Kym wants to even do more than that and be traveling constantly. So, tell us about your journey into private practice and now to where you are today. 

Kym Tolson: Oh, my God! It's such a journey. It feels like lifetimes ago, really.

Um, you know, so I started out in community mental health, of course. I think all of us start there and, you know, obviously totally burnt out, as most people do. Then it went to, like, a private group practice kind of situation. And then, you know, from there I was like, “Okay, I think I'm ready to move on again to do my own private practice.”

So I moved into, like, a brick-and-mortar office. And then yeah, I was doing like you do, like, I think I was taking eight weeks of vacation a year and it just isn't enough. I've got, like, this wanderlust. Like I just want to go. Like, I've always been that way. So eventually I took a course to teach me how to do online therapy.

That was before COVID, before it was like everybody had to do it. And I did that and then I started traveling and then we literally actually sold everything: our house, our cars, our belongings, and we moved down to just randomly pick the place Hollywood, Florida down by Miami. We moved down here. Then COVID hit.

We had this big plan. We were going to like, “Hey, look, I lived there for like a month.” Maybe we'll move somewhere else and live there for a month, ‘cause my boyfriend can also work remotely. So once I got the telehealth thing going, that was the plan and then COVID hit. So now I've decided: OK, COVID is letting up a little bit, so I've recently launched sort of like a new brand, I guess you would call it, called The Traveling Therapist. And right now I'm just traveling constantly pretty much every other week, I'm going somewhere and I'm taking my practice with me. So I still have, I see about 10 clients now, per week. So I'm doing that while I'm on the road, pretty much is where… where… where it's taken me to this point.

I'd like to get rid of this apartment we have now and just kinda like do literally like an Airbnb somewhere else every couple of months.

Patrick Casale: That's really wonderful to have that vision come to fruition and obviously hit some roadblocks with COVID unexpectedly. You know, how scary or, maybe it wasn't, like, what did it feel like to just sell everything and just say like, “we're going to kind of try to do this and pursue this dream that way?”

Kym Tolson: You know, it was scary and exciting at the same time. The hardest part was like realizing the attachments I had to all my stuff, you know, it's like, it's like, “Wow! Do I want to sell my bed?” My bed that I love, you know, it's like that kind of thing. So that, I mean, that was the hardest part for me.

Really, it wasn't that scary. I don't think it was. More just, like, exciting for me. Like we're going to embrace the unknown and just do this. And then I always knew like, “OK, it's not the life for me.” I can settle down, like whenever I want to. So that was kind of what was going through my mind. 

Patrick Casale: That makes sense. So just not really scared of what was going to happen next, but more so like relinquishing possessions and just the things that you were tied to.

Yeah, totally makes sense. And now, like, you're traveling, you've got multiple streams of income. Talk about what it's taken to, like, start to do those things, because I think a lot of therapists don't see what can be possible. They have a hard time of realizing our talents and how we can apply them into different areas in business ownership, because typically we're not business owners or we don't know how to be.

Kym Tolson: Yeah. I kind of decided I didn't want to see as many clients as I was seeing. So I realized I had to scale up. Right? And there's so many ways to do that. Like, you can go into a group practice or you can start doing, like, group therapy to like serve more people at the same time. Or you can start doing these other side hustles, like a lot of us have now, like building courses or trainings, that sort of thing to, to sort of serve a lot of people at the same time, for more income and then have more time for yourself. For your life. 

So, you know, I… I realized that's what I was going to have to do to really live the life I wanted to live, to cut down on my caseload.

So, What I do is I kind of like, just pay attention to areas where people are asking a lot of questions. So, like, telehealth and insurance billing was a huge thing, especially when I decided to go all telehealth. I was like, “Oh crap! Now, can I even do this? Because I'm an insurance provider. So, in my panic, trying to figure that out I started writing a course and that led me to say like, “I need to write this for other therapists too, so that they can learn to do the same thing and give them the information. So they're not in the same place.”

I was like, “OK, I want to travel. I want to do this.” But can I even with an insurance-based practice? And all the while knowing I needed to scale up. So the two things kind of came together and then I was able to, you know, come up with this course that turned into a side hustle and now brings an income for me.

And that's, you know, that's evolved, evolved into a bunch of other things. Um, from starting that one thing. So it's, it's kinda been cool. Like it was never really the plan, but it's just sort of, like, evolved into this thing that I've got going on now. 

Patrick Casale: That's really cool to see that succession and you don't have that plan and then it starts to get momentum and you start to see what else is possible.

And, you know, obviously you have a reputation in the community about really understanding the insurance side of things. And I think that's a place where therapist's really struggle again, because like what we don't know, we don't know and it feels intimidating. So tell us: Why the insurance side of things? Like, it sounds like you're traveling, you recognize the need and then all of these things start to get created.

And does it ever feel frustrating to deal with that topic? Because it is a frustrating situation.

Kym Tolson: Oh my God. Yes, especially right now, because I mean, not that the pandemic  is ending, but a lot of the insurance companies are starting to, like, pull back on these, like, blanket telehealth allowances they were making for all the clinicians.

So it, you know, it does start to feel a little bit frustrating. You're trying to help guide people through it, especially people that want to live the life I'm living. You know, everybody's worried now it's like, “can I?” You know, for example, Blue Cross Blue Shield is now saying you have to. like, have a physical office located in the state that you're credentialed in, which is insane. Right? ‘Cause I live in Florida. I'm licensed in Virginia. That's going to be a problem if they really start enforcing that.

Um, so yeah, things like that are… are huge, you know? Uh, but I also feel this calling to, like, help people navigate it too. So… so that's… that's why it's really evolved into like a Facebook group and, you know, a course, and then I started a membership around it, you know, just to give support around how frustrating that topic really is because there's so many nuances for therapists and, you know, a lot of us want to take insurance because it's, um, you know, it… it feels like the right thing to do in my practice, like to serve people that want to use their insurance.

So I'm willing to navigate the frustrations, but yes, it is extremely frustrating. 

Patrick Casale: Yeah. And I think there's a lot of misinformation out there, especially as COVID has been going on about what you can and cannot do as an insurance provider. Especially a lot of people I still see to this day, like, “Can I see anyone in any state right now? Because COVID has this, like, blanket telehealth law?”

It's like, “No, you definitely can not.” You've got to pay attention to, like, the ever-evolving insurance processes and requirements. It is a little crazy though. Like, if you're licensed in Virginia, living in a different state. Traditionally, like, we don't have to have an office in that state.

So it's really messy and it's really frustrating. And it's frustrating for clients too. Are there, like, common questions or mistakes or themes that you see with telehealth and traveling and insurance right now with people who need support around that?

Kym Tolson: Well, I think what a lot of people don't realize right now, kind of along what you're saying is like… like for example: I was in Las Vegas last week. Right? 

So if you're traveling and working, you need to make sure you can also be providing services in that state. Like, that they allow you to do that. Even if your clients are in the state of licensure, you still have to check with that state to make sure you can practice there. So a lot of people don't realize that.

I'm actually in the process of putting together like, um, like a complete guide for that. I’ve contacted every single state in the United States and I'm waiting to get answers from everybody about that. Like, can you practice in the state? Like Nevada: you can! So I was able to see clients there, but, like, South Carolina: they've never given me an answer. And there was a handful of states, I can't think of what they are, but they say, “Absolutely not! You cannot be in the state practicing. You must be licensed in the state, even if your clients are in Virginia.”

So, you know, I guess I would just put that out there to people to caution them. Like, that's a real thing that you have to pay attention to. 

Patrick Casale: Totally! Yeah. That's such a good point. Do so at your own risk, people! 

Like some people are still gonna do it. I'm not going to tell you what to do, but do so at your own risk. 

And honestly, I don't even know how the hell they would figure that out. But like Kym has said: contact the licensing board. See if you can get answers. (That's another frustration is a lot of the times the licensing boards don't even respond.)

So it's like: Just do so at your own discretion and document and cover your asses to the best of your ability, um, with all of that stuff. 

And I appreciate that you're making a guide like that. That sounds super helpful for people who are asking these questions. 

Kym Tolson: Thank you. Yeah, I'm doing it for LCSW, LPCs and LCMHCs. Uh, yeah. Uh, back to the credentials! (laughs) But yeah, somebody is helping me with the LPC part. So we're going to combine it and do like, kind of like a freebie, you know, getting back to the side hustle thing. We're going to make it like a freebie giveaway thing for this traveling therapist course that I'm working on.

It's kind of like an opt-in. Yeah, if that makes sense.  

Patrick Casale: Yeah. That makes a lot of sense. And it's funny because in North Carolina, we used to be LPCs until a year ago where the board decided to change us to LCMHCs. Never told anybody! And then it was like, “Oh, so I have to update all of my paperwork. I have to talk to the insurance companies to see if I have to re-credential. It was a mess! Traditional to north Carolina's process: it's always a mess. 

But yeah, that sounds really cool. And you have a lot of different offerings. So what do you think about the comment where, like, people are like, “I just want passive income.” Like, I hear that a lot from people. What's your reaction to that? 

Kym Tolson: Nothing's passive. I do have, I do have one stream that's pretty passive right now, but it took a lot of building to get it there. I've got, like, hypnosis MP3 downloads that I sell. Like I had apps made and I sell them on the app stores and also on Etsy. Um, so I'm not doing a lot with that. I don't market it at all and they just sort of sell themselves. So that's like an exception to the rule.

I think the rest of it takes a TON of work. Like a lot of just, you know, building your audience and then nurturing your audience and, like, actually coming up with good products. You know, and then you have to, like, follow up with that and help people, you know, navigate the products, you know, so there's a lot that comes to it.

You know, the dream is, like, to have this evergreen kind of funnel that, you know, people just fall into and then they just buy your stuff and then you just get money in your bank account. But that doesn't always… that's usually not how it goes. I know, you know that Patrick! (laughs)

Patrick Casale: I hear this, you know, this comment all the time from people, because I think therapists are kind of getting burnt out and understandably so.

And it's like, “I want to go into coaching. I want to go into course creation or be an author or whatever.” And I applaud all of it. Like, it's not straightforward and it's not passive. Like, there is a lot of behind the scenes work. There's a lot of frustrations. There's a lot of… potentially… thoughts of, like, giving up and saying like, “This can't be successful.” I've experienced that. 

Um, with all this stuff you're creating, do you experience that ever where you're like, “This is just not going to work,” or, “I can't do this.”

Kym Tolson: I mean, constantly, like I'm in the middle of a launch right now for a new product. You know, I've just built a new audience and I've got a new product out and it is like the week that you're launching stuff (or two weeks or however long) it is so emotional!

You know that meme where you're refreshing the screen? Like, “Have any sales come in? Have any sales…” You know, I'm like that, you know? And so, and then you get some sales and you feel like on top of the world, and then it's like a day goes by, nothing happens. And it's this constant rollercoaster.

So yeah, that part, and sometimes it's like, “why am I doing this to myself?” But then I'd have to remember: a lot of travel! I don't want to have to be seeing clients 40 hours a week or whatever. 

Patrick Casale: That's so spot on. It is a rollercoaster. It really is. You know, it's, it's a lot of emotion. 

It's a lot of vulnerability of: “Are people going to buy my stuff?” If they don't buy my stuff, is it because my stuff isn't as good as other people's stuff? Like, “how many shares did I get on this post?” And like, “did anyone comment?” It's really challenging and it is an emotional rollercoaster. It brings up a lot of insecurity sometimes in the moment.

 Kym Tolson: It's like, “Oh shit, I've got rid of like my caseload and what if I don't sell another thing for the rest of my life? Crap! Then what am I going to do?” 

Patrick Casale: Totally comes up! Of like, “nobody's ever going to buy anything from me again! I got rid of my caseload! My world is going to just implode up in flames! I'm going to have to sell my house!” Like all those fucking crazy thoughts start coming up. And none of it is rational, you know?

And like, sometimes this stuff is about seeing what sticks and like, you might have a really good idea and it just doesn't work for whatever reason. But then you pivot to something else that does. And I see that a lot. And, um, I think that's a really normal part of this process. 

Kym Tolson: Yeah. That's what all the big coaches talk about, you know, like when they look back on their path, all the failures have led to the success, you know?

So I do try to remind myself that, you know.

Patrick Casale: Yeah, failure leads to success and growth, and I think we need to normalize it. And I've been trying really hard to talk about this: We all fail. We all make mistakes, but that means we're trying and we're putting ourselves out there and hopefully we're learning from those mistakes and those failures with how to do something differently the next time.

Kym Tolson: Exactly! Yeah. Learn from it and try not to give up. Don't quit.

Patrick Casale: As an entrepreneur, you have to be resilient and you have to bounce back from things that maybe don't go well. And for any of you starting a practice or thinking about other streams of income: there are going to be times that are going to be hard like Kym said. Like, where you question your ability and your competency and whether or not you're ever going to be successful. And that's really normal. 

So if you're feeling that way: don't despair. Just really recognize that other people experienced the same exact things. And it's really more about: “do you ask for help or guidance or feedback,” or, “how do you pivot if something doesn't go as planned?” And we need to have that adaptability to evolve as business owners. 

Kym Tolson: Yeah, absolutely. And having, you know, having a really good support group around you that's gonna, like, cheer you on when you're ready to quit (laughs) has been key for me. I've got this group of, like, women: we all have Facebook groups, we all kind of like do launching of products and we just… we just like freak out with each other, like, “oh my gosh!”

And we support each other. “Don't give up! It's okay!” Like I had to send out a second email with a broken link, you know, that whole thing the other day. And I was like, “Oh my God, I can't believe I did that.!” They're like, “it's fine! It's okay! It's going to be okay. Nobody even notices that stuff.” 

I'm like, “yeah, you're right.” 

Patrick Casale: That's so true. It's… People DON’T notice it. And it's like, we have a lot invested in it emotionally and energy wise, so it makes sense that we are more critical of the outcome because it's our… our projects. So it's just interesting when stuff like that happens. And then we just shift our energy and our focus. 

So, um, with all the traveling that you're doing right now, are there specific places that you really want to end up or is it just going to be like continuous?

Kym Tolson: It's just going to be continuous right now. I don't have a destination in mind. I mean, ironically, living down here in Hollywood, we realized that we love it here. So it's like, we've been traveling to a lot of other places lately and it's always like, when we're there, we're like, “you know what? Home is actually better.”

So we're kind of realizing, I don't know… Maybe we already found like our perfect place here. Um, but who knows, you know, we might find some other place that's amazing too. So right now I'm just… Right now, I'm just like in that exploration. Like, I just love to go to a new place and, like, immerse myself in the culture and just, like, live there for a little bit, you know?

Patrick Casale: Totally. It's a lot easier to acclimate and get familiar and really enjoy and be present if you're not just going for three days or you're not just going for a week and turning right back around. I know a lot of people don't have the luxury of doing that, you know, and other responsibilities or children or pets or whatever, but the beauty of being a small business owner and the reason we leave community mental health jobs is because we want more freedom and autonomy and flexibility. 

And travel is something that I see so often that so many therapists want to do more of, but typically, maybe don't even know how. Like, “what am I going to do for PTO? What am I going to do for X, Y, and Z?” 

The beauty of it is like, you get to make your business what you want to make it, and you get to kind of call the shots and make those decisions.

And if you want to work a couple of hours while you're traveling: do it. Don't let other people shame you for that. If you want to just disconnect and disappear: do that too. 

But yeah, I really love your concept and I love your travel group and, and just the fact that you're living this like nomad lifestyle right now as a… as an entrepreneur.

Kym Tolson: Yeah, it's, it's been so cool. And I've mentioned that traveling course I'm working on, but I'm so excited about it and Patrick's actually a contributor to it. As I've asked basically every therapist I know that travels to contribute to this course in some way. So like you said, most people, some people don't know how to do it or how to, like, travel and work and all that.

I'm just so excited about this and your… your contribution’s great. Patrick's got great tips on how to, like, make it work, you know? 

Patrick Casale: It can work out. Like, it can! And it's just about understanding how to strategically plan it, you know, in terms of how you speak to your clients, how to step away, how to budget accordingly.

And more importantly, how to disconnect when you're out of the office, because so many of us don't practice what we preach in terms of self care. And I think as therapists, we really struggle with that. It leads to burnout and then it makes us really resentful of the jobs that we do. And we just don't want to see that in the profession. it's hard enough as it is.

But Kym: tell us where you can be found, where people can get your information, your stuff, like you've got so much to offer right now.

Kym Tolson: Yeah, so you can, um, you can go to KymTolson.com, uh, K-Y-M-T-O-L-S-O-N.com or TheTravelingTherapist.com. That's brand new. It's not finished, but it's almost there.

So I can also offer a couple of different things. So I specialize in the insurance stuff. So if you want to reach out to me about that: I'm happy to help you. If you want to reach out about the traveling stuff: I'm happy to help you with that. 

And I just now, recently, launched a new course that trains virtual assistants on how to become insurance billers for your practices. So, if you have anybody that you think would want to be trained in that: reach out to me. Um, so there's a bunch of different kind of streams going on right now.

Patrick Casale: A lot of cool stuff y'all and that's what you can see for yourselves: if you're starting your businesses and you can't see what's next, the ability to get creative as entrepreneurs.

I think we all go into small business ownership because we're creative, human beings. And we have a lot of ideas and sometimes they work and sometimes they don't, but just continue to try. And I really appreciate you being on Kym and you can find her information: we'll share that in the links in the podcast. Um, thank you all for listening.

Download, subscribe, share. Podcast for small business owners and private practice owners to really try to see that there's a lot more out there for you. So tune in next time and we will see you soon. Thanks everyone!