Telepractice- Your Questions Answered

This post summarizes my experience over the last six months working as an independent contractor for Presence Learning.  The opinions expressed here are solely mine without compensation.  If you would like to learn more about telepractice services at Presence Learning, then you can watch this link about the company.

A Day in the Life of a Presence Learning Telepractitioner

If you are like me and are a "hands on" learner and you want an opportunity to see a telepractice therapy room, then email me at

Before I delve into my telepractice world, let me provide a little background about my life as a speech pathologist.  I began this fabulous career in 1995 as a speech assistant at elementary and middle schools and then earned my masters in December 1998 at Northern Illinois University.  Over the course of my career, I have worked in both public and private elementary and middle schools, a severe to profound system, acute and rehabilitative hospitals, and early intervention.  I know that seems like a big list, but my time in the hospital settings were per diem.  In the summer of 2012, I opened my private practice part time and then grew to full time less than two years later.  My cozy space is in my home and I run a one-woman-show, which means that I take intake calls, provide evaluations and therapy, and submit my own insurance claims.  Once I found my rhythm in private practice, I noticed blocks of time that were especially hard to fill with clients between the hours of 11 am and 2 pm weekdays.  Not only did I constantly have this down time, but I also noticed a dramatic dip in therapy attendance across the board when the new year began and insurance deductibles reset to zero.   I started researching telepractice services to fill those daily voids and provide a reliable source of income during those periods of frequent cancellations and low attendance.

Last February, I took some time to speak with three telepractice companies and decided to pursue working with Presence Learning.  With almost six months under my belt, I think that I have found my telepractice groove and filled those voids while enjoying predictable reimbursements.  Now that I paved the way for myself, I am happy to help my peers in their pursuit of this new world.  Below are some of the most popular questions that I am often asked about working in telepractice.

*How many hours a week do you work in telepractice?  At Presence Learning, I am required to work directly with clients for ten hours weekly.  In addition, I am compensated for time spent billing, consulting with parents, writing IEPs, documenting and planning sessions.  I am also paid if a client cancels with less than 24 hours notice or does not show for a session.  On average, I bill for 10-13 hours a week, which includes a combination of direct therapy time and some of the other indirect examples cited above.

*How many kids are on your caseload?  My position is a bit different than I expected it to be as I work with clients who are home schooled in virtual sites across California.  Many of my sessions are individual, but a couple are group speech.  In total, I have eleven clients right now, two of which are temporary coverage for RTI clients.

*How often are you paid?  I submit my bills on the last day of each month and then receive a direct deposit two weeks after invoicing.

*Do you need to find your own clients?  No, Presence Learning always assigns you clients.  This was important for me because I wasn't quite sure where to begin with telepractice.  I know that you can do telepractice on your own, but this was such a new world for me that I wanted to start with a reputable company and have them find my assignments.

*How does therapy work?  This is the most impressive part of working for Presence Learning: they have recently updated their therapy platform and it is AMAZING!  Clients meet me in "my therapy room" by following a direct link to my space.  We both need to use a computer (there isn't enough screen space to use an iPad) with a webcam to see each other.

One of the links that I am allowed access to as an employee is the library.  This "library" is loaded with lessons and activities that other providers like me have loaded into this storage space.  If I cannot find something I need in the library, then I can scan and upload documents or download activities on my computer and load them to the Presence Learning library.  I am always given the option to share things that I load publicly or keep it private for my use only.  This allows me to utilize those products that I love incorporating into therapy without infringing on copyrights.  I can also create my own flashcards and memory games using images stored in the library or my own uploaded pictures.

After searching and previewing documents, I began creating "queues" to store plans for articulation, language, pragmatics, vocabulary, and seasonal tasks right into my therapy room.  These queues appear condensed along the right side of my monitor so I can easily grab what I need for each session.  In addition to being able to load and store activities, I can collect data on client goals while in my sessions with a simple click of a button and even write SOAP notes.

Finally, there are tons of interactives in the therapy room.  During sessions we can activate a pencil to circle answers, play games using stamps as markers, add dice or spinners, display timers, and so much more!  I can reward clients for accurate responses with a quick, pre-stored animated video or search for a character of high interest such as Peppa Pig or Mickey Mouse to display a short animation.  Finally, I can load video contents into my queues to work on just about any speech/ language task that my little heart desires.  For example, I have stored a video of someone reading a seasonal book in a queue to work on answering WH questions.  Needless to say, clients are never bored!!  In fact, it is REALLY hard to say goodbye to them when time is up because many are so motivated by all of the features in the platform.

*Do you get holiday and summer breaks?  In my position, I have the same holiday breaks as typical school systems, such as MLK day and President's day.  I also had two weeks off at Christmas and will get a week off during spring break.  While I am not required to work in the summer, I understand that I may be offered an opportunity for ESY with any clients that are currently on my caseload qualifying for summer speech and language therapy.  This may vary from one contract to another though.

*Do you need to be certified in other states?  Yes, as of right now, I need to maintain my certification in the state that I live in, and Presence Learning will reimburse me for certification and renewal fees for licensure in states where my clients reside.  Since Presence Learning has a large client base in California, I was strongly encouraged to gain state licensure in CA to broaden my scope for a caseload.  It took a little work for me to complete this process, but Presence Learning fully reimbursed me and paid for time spent completing licensure tasks such as fingerprinting.

*Is your compensation similar to private practice?  While I am not authorized to discuss salary and reimbursement, I will say that Presence Learning was the only company willing to negotiate a starting rate.  Having worked as a contract therapist before, I knew the reimbursement rates would be lower in comparison to my private practice charges.  My intent was to fill a 2-3 hour daily void with clients and provide a reliable source of income during those periods of frequent cancellations and low attendance.   Thus far, my position at Presence Learning has fit both of those bills.