Questions clinicians ask before they join Pluto, answered plainly. If yours is not here, email admin@plutomentalhealth.com, or go back to work with Pluto.
Clinicians interested in Pluto are encouraged to submit an application (linked), which begins a dialog with Pluto's admin. Typically, admin will send you Pluto's independent contractor agreement just to read. There may be followup questions. Next, applicants are often invited to attend an information session (if there is one upcoming). After the session, a 1:1 call/interview is scheduled with admin. The purpose of that first call is to make sure the applicant has a chance to ask questions about Pluto's model. If both parties are interested in moving forward, a 2nd interview is often scheduled with a Pluto supervisor. If that interview goes well, an e-signature version of the independent contractor agreement is sent to the applicant for signing.
After signing the ICA, clinicians are sent an invitation to create an account in Pluto's HR software. In their portal, clinicians upload important documents (malpractice insurance, proof of licensure or registration), and other info. Associates are able to consult with and choose a supervisor from Pluto's supervisor roster. Fully licensed clinicians need to complete their DataSpring (aka CAQH) account and grant Pluto access to it so that we can begin submitting credentialing applications. There may be trainings to complete, and clinicians can also build their web profile in the HR portal. When everything is done, the clinician emails admin to activate their account, and the activation date is the Start Date.
Signing the agreement does not start anything on its own. Your Start Date is the day Pluto activates your EHR account, and that happens after you email admin to say you are ready and the rest of onboarding is complete. Administrative fees begin on the Start Date. The time between signing and activation is used for credentialing, profile setup, and onboarding.
Yes. Plenty of people sign before they are registered. Signing does not let you see clients or present yourself as a Pluto clinician, and your account is not activated until your registration is active, your signed supervisor agreement is on file, and onboarding is done. If six months pass and you still have not started, Pluto can end the agreement with written notice, and neither side owes the other anything.
Benefits can be a nice perk in some work contexts. In the outpatient mental health space, many practices offer a number of benefits and things for "free" such as health insurance, supervision, malpractice insurance, office space. When you look closer at this arrangement, those things aren't free, they're being paid for with session revenue. Unfortunately, those benefits and "free" things are often not worth the huge portion of revenue that clinicians need to give up for them. At Pluto, we've decided the most equitable system is to maximize clinician revenue so clinicians can choose what health insurance and supervision works best for them. This gives clinicians more power, and also prevents clinicians from feeling like they are trapped at their place of work.
An independent contractor runs their own practice and contracts with Pluto for specific services, rather than working for Pluto as an employee. Contractors control their own schedule, caseload, and clinical methods, can work with other practices at the same time, and handle their own taxes and professional insurance. The particulars of the relationship are detailed in the independent contractor agreement; feel free to request a copy.
The main advantages are autonomy and economics. Contractors set their own schedule and caseload, choose their own clinical methods, set their own out-of-pocket rates, work with more than one organization at a time, keep the full reimbursement for their sessions minus flat fees, and can deduct business expenses. The main disadvantages are the things an employer would otherwise provide: there is no employer health insurance, paid time off, retirement match, or unemployment coverage; contractors pay self-employment tax and manage quarterly estimated taxes; income varies with caseload and payer timing; and contractors carry their own professional insurance.
No. Clinicians can contract as individuals or through their own entity, and can switch between the two at any time with written notice and a new W-9. Nothing else about the agreement changes with a switch. Two practical notes for anyone forming an LLC: the registered agent needs an Oregon street address, and that address becomes public record; and Pluto cannot serve as a clinician's registered agent.
Clinicians are independent contractors, so all taxes and withholdings are their own responsibility. There is no W-2 and no withholding, and quarterly estimated taxes are the clinician's to manage. Pluto requests a W-9 by email during onboarding. Supervisors receive a 1099-NEC each January for their note-review compensation.
Professional liability at $1M per claim and $3M aggregate. Cyber liability at $15,000 per claim; an endorsement on the malpractice policy satisfies this, and the add-on usually costs $30 to $200 a year, since cyber is rarely included by default. General liability at $1M per occurrence, required only for clinicians who see anyone in person, and it must be in place before the first in-person session; the malpractice declarations page is worth checking first, since general liability is often already included. Pluto is named additional insured on the general liability and cyber policies where the insurer allows, never on the malpractice policy. Certificates go on file at onboarding and at each renewal. Associates should expect roughly $150 to $300 a year in total.
The clinician. Malpractice coverage follows the license, so the clinician must be the named insured. An individual policy covers only the clinician; carriers will not add the clinician's own LLC to it, and a policy that names only the entity can leave the clinician's personal defense uncovered. Covering the LLC as well takes a separate business-entity policy, usually a couple hundred dollars a year, and it is optional for Pluto's purposes.
As an independent contractor, you set your own schedule and take time off whenever you want, without asking or notifying admin, though you would have to notify your clients. For a long or open-ended absence, you can ask to close your EHR account. Depending on the length of the absence, credentialing may need restarting when you return.
Pluto clinicians are able to build their own profile page on Pluto's website, but a personal website belongs to the clinician permanently, and can help potential clients find them directly. Pluto's contractor agreement is non-exclusive, so clinicians run their own websites and branding as they see fit.
Per-session fees: $15 per insurance-billed session, and $6 per out-of-pocket session documented in the clinic EHR (out-of-pocket work kept entirely outside the EHR has no fee). Low-volume months: in a calendar month with 5 or fewer sessions, a $70 minimum administrative fee applies instead of per-session fees; it is waived for the first partial month and the first full month. Optional services: Benefits & Denials Support at $1 per insurance-billed session, New Client Coordination at $12 per client, and a Pluto Google Workspace account at $17 per month. Payment processing: client card payments have a 3.5 percent pass-through; the insurance-paid portion never does, and ACH payments cost nothing. Increases: the per-session fee cannot rise more than $1 in any 12-month period, with 60 days written notice.
Reimbursement rates are different for each insurance payer. The current clinic average for a 60-minute individual session is $149. Pluto's fee is $15 per session, so the average take-home is about $134 per session, before any additional costs, like office use, supervision, and taxes. Exact per-payer rates are confidential under the payer contracts, so those are shared after contracting.
An optional service called Benefits & Denials Support, at $1 per insurance-billed session. The clinic monitors submitted claims for denials, rejections, and aging, handles the routine fixes (resubmission with corrections, eligibility verification, standard appeals), and follows up with payers on old claims. For complex appeals or write-offs above set thresholds, the clinic explains the situation and asks for the clinician's approval before acting. Clinicians receive a monthly report of claims worked, denials resolved, appeals filed, and open items. Opt in or out by email at any time; changes take effect at the start of the next month.
New Client Coordination is an opt-in service. Pluto's intake staff handle a new client from first contact to first session: contacting the person promptly during business hours, running a basic insurance check, screening for fit, scheduling the consultation in the EHR, creating the client record, sending intake paperwork, and briefing the clinician beforehand. The fee is $12 per client, and how it applies depends on where the lead came from. For inquiries Pluto generates, the fee applies only if the person attends a first session. For a lead the clinician brings and passes to intake staff, the fee applies per lead, whether or not a first session happens. Clinicians who do not opt in receive inquiries directly and handle their own scheduling and intake, at no fee.
A claim is the bill sent to an insurance payer for a session; the payer processes it and sends the reimbursement. For associates, the supervisor submits claims after signing the progress note. Fully licensed clinicians submit their own claims, which is two clicks of your mouse. Once a claim has been submitted, if you have opted into Benefits & Denials Support, Pluto takes responsibility for monitoring that claim in case it is denied or needs to be resubmitted.
Clinicians receive the full insurance reimbursement for their sessions, plus any client payments collected through the EHR. Payments are sent by ACH twice a month. The timing of a given reimbursement depends on when the insurance payer pays the claim. Pluto's admin fees are billed separately each month; they are not deducted from these payments.
A clawback, also called a recoupment, is when an insurance company decides it should not have paid a claim and takes the money back. This happens in any practice that bills insurance. Payers pay claims first and review them later, so a payment can be reversed months after the session. Common reasons include the client's coverage having ended before the session, the wrong plan being billed, the documentation not supporting the code that was billed, or the service not being covered under that plan. Payers usually do not send a bill for the money. They deduct it from what they owe on newer claims. In a group practice, the payer takes the money back from the group, since the group holds the payer contract, and the group and the clinician then work out who covers it.
It depends on why the payer took the money back, and Pluto sends the clinician the payer's stated reason in writing. The clinician covers clawbacks caused by their documentation, the codes they selected, late or unsigned notes, medical necessity, their own licensure status, or a missed deadline on a payer records request. Pluto covers everything else. Associates do not cover clawbacks caused by their supervisor's review. When a clawback has more than one cause, Pluto splits the amount. When a clinician ends up covering a session, the administrative fee for that session is credited back. Section 9 of the contractor agreement has the full policy.
Pluto offers infrastructure (credentialing, billing, space, and admin), not client referrals. Inbound inquiries do come in through the website, clinician profile contact forms, and the clinic phone line, and they are matched on service format, availability, and insurance. But they are not guaranteed, and no one should sign expecting them. A practice model that depends on a referral pipeline is not a good fit at Pluto; clinicians here bring or build their own caseloads.
An inquiry that matches a clinician is forwarded to them directly, at no fee, and the clinician contacts the person and books the consultation. Each public profile also has a contact form when the clinician is marked as accepting. The expectation is a response within 1 to 2 business days; repeatedly not responding to leads can take a clinician out of the rotation. Clinicians who prefer not to handle first contact can opt into NCC.
When getting a client lead, a great first step is to offer them a free phone consultation, within 1 to 2 business days, to make sure there is a good fit. If both sides want to move forward, the clinician creates the client record in SimplePractice, confirms the client's insurance coverage (the EHR runs an automatic eligibility check, and the clinician confirms the details at intake), schedules the first session, and sends intake paperwork. Clinicians who opt into NCC have these steps handled for them.
It depends on how much effort you put into marketing yourself. Clinicians tend to fill faster when they have a specific population, niche, or brand, when they use modalities that are currently popular with potential clients such as EMDR or IFS, and when they promote themselves through multiple directory listings, their own website, and Instagram or other social media. Clinicians who arrive with existing clients start full. Building from nothing takes sustained effort.
No. Clinicians can see as few or as many clients as they want. However, Pluto does pay for each clinician's EHR account subscription, and if a clinician is on leave or has 5 or fewer sessions in a month, a $70 fee is applied to cover the EHR cost.
Pluto provides the Notice of Privacy Practices, the Informed Consent for Therapy, the Practice Policies, the Telehealth Consent, the Credit Card Authorization, the demographics form, the intake questionnaires, the Walk-and-Talk Consent, and the Consent for Recording and AI-Assisted Documentation. They are the same for every client, set up in SimplePractice, and used as they are. Each clinician's own documents are their Professional Disclosure Statement, which holds their own policies, such as cancellation and how to reach them, and the Good Faith Estimate for self-pay clients. If a form is missing or one of Pluto's documents needs a change, send admin a draft or a description. Pluto makes the change for everyone, or, when there is a strong reason, builds a separate version for that clinician.
Client relationships are not the property of either party, and each client chooses: continue with the clinician, move to another Pluto clinician, or go elsewhere. There is no non-compete and no non-solicit. Either party can end the agreement with 30 days written notice. The clinician keeps record access for at least 90 days after leaving, to support transitions and pending claims, and remaining reimbursements are paid out within 4 weeks of receipt, minus any outstanding fees.
Yes, for insurance billing. To bill insurance through the clinic, an associate works with a Pluto-contracted billing supervisor, who reviews and signs every insurance-billed note. The insurance companies require this for associate-level billing. Associates choose from Pluto's contracted supervisors and meet with that supervisor at least once a month. This is separate from what the licensure boards require, which is 2 to 3 hours of supervision per month depending on session volume. Most associates use one person for both, but you can also see an outside supervisor for your remaining board hours in addition to the monthly meeting with your billing supervisor.
Associates review Pluto's supervisor roster, and once admin gives the go-ahead after an interview, you can schedule consultations with supervisors you are considering. If both sides agree it is a good fit, the supervisor provides an Associate-Supervisor Agreement for the associate to sign. The supervisor may draft that agreement themselves, or generate a custom one in Pluto's HR software. Either way, a signed copy stays on file with the clinic, and billing cannot begin until it is there.
Your primary supervisor is your billing supervisor: they are contracted with Pluto, they review and sign your insurance-billed notes, and their agreement includes the payer review requirements. A secondary supervisor is anyone else you work with for supervision, whether that is another Pluto supervisor or someone outside Pluto you hire and pay directly. Secondary supervisors do not sign notes and have no role in Pluto's billing. A board supervision plan can name up to two supervisors, which is usually where a secondary supervisor fits.
For PC and MFT associates under OBLPCT: at least 2 hours in a month with 45 or fewer direct client hours (at least one of them one-on-one), and at least 3 hours including 1.5 one-on-one in a month with 46 or more. Group supervision can cover part of the requirement, within the board's limits, and Pluto aims to run regular group sessions so associates can reduce supervision costs.
We ask that you wait until after an interview has taken place and admin has given permission to contact supervisors. But this usually happens before signing the agreement, yes.
Supervised billing ends the day the license is active. That is a payer rule, not a Pluto choice. The supervisor stops signing notes, and the clinic starts credentialing the clinician under their own NPI as early as it can. Until a given payer approves the clinician individually, they cannot bill that payer through the clinic, but they can see self-pay clients and bill insurance through any channel outside the clinic during the gap. The associate agreement stays in effect, and it can be replaced with the fully licensed agreement whenever both parties want.
Pluto's current insurance panels are listed at https://plutomentalhealth.com/insurance. Clinicians can decide which insurance companies they want to work with.
DataSpring, formerly CAQH ProView, is the central online database where healthcare providers maintain their professional information: licenses, education, work history, malpractice coverage, and practice locations. Insurance payers pull from it during credentialing instead of collecting the same paperwork separately. Keeping the profile current, and re-attesting when the system asks, keeps credentialing moving.
Within 24 hours when possible, and no later than 7 calendar days after the session.
Pluto can sometimes perform retrospective sample reviews aimed at preventing clawbacks. Such a review would not hold up a claim, and if a reviewer finds a concern, the clinician hears about it within 5 business days and addresses it however they judge appropriate.
Using transcription and AI software poses HIPAA risks, so Pluto recommends clinicians use such tools with extreme caution. If you wouldn't want your own therapist to record your sessions, then you should probably avoid recording your clients. But the decision is completely up to the clinician. Those who use these tools are still responsible for meeting HIPAA, Oregon law, ethics rules, and client consent requirements.
No. Work billed through Pluto has to live in Pluto's SimplePractice account, because that account is what makes it Pluto work: claims go out under the clinic's contracts, supervisors sign associate notes there, eligibility checks run there, and the records are the clinic's system of record. A client seen in your own account is your own private-practice client, not a Pluto client, and cannot be billed through the clinic. You are welcome to keep your own account for work you do outside Pluto.
Office rental is optional and month-to-month, under a separate license agreement. Either party can end it with 30 days written notice. The available formats are a dedicated office, weekly full-day blocks (7am to 9pm), weekly half-day blocks (7am to 2pm or 2pm to 9pm), weekly hourly reservations, and single dates. The conference room costs $25 an hour; internal consultation meetings there are free with scheduling approval. To see a copy of the office use agreement, reach out to admin.
An office comes with internet, utilities, and use of the shared common areas, and offices are generally furnished with chairs, couches, desks, lamps, and clocks. Clinicians with a dedicated office can bring their own furniture with approval and may receive keys. Shared rooms use clinic furniture; the room can be locked during a session, but it should not be left locked, and belongings should not be left behind.
Yes, it is possible. Each insurance payer requires service locations to be registered under the contract, so adding a location takes some setup on the clinic's side. Please talk to admin about it.
No. None of our current insurance contracts restrict clinician residence or location during sessions. In the future, our OHP contract may restrict one or both of these. What matters now is an active Oregon license and the client being located in Oregon at the time of the session.