The short answer
Ask who makes clinical decisions, whether there's a caseload minimum, who controls your schedule, whether the contract is exclusive, who handles credentialing and billing, when you're paid, what happens with no-shows and denials, who carries malpractice, and how you can leave. Get the answers in writing before you sign.
What should you ask before you sign?
Ask the questions that decide your day-to-day life, and get the answers in writing. Recruiting conversations focus on the good parts. The contract decides what actually happens.
The list below is grouped by topic. You don't need to ask every question, but the ones about clinical control, pay, and leaving are worth asking every time.
Clinical control
- Who decides session frequency, treatment approach, and when a client is ready for discharge?
- Are there required modalities, scripts, or session lengths?
- Can I decline a referral that isn't a clinical fit?
- Can I set a minimum client age, or see adults only?
- Are there productivity targets, and what happens if I miss them?
A reasonable answer sounds like: "Clinical decisions are yours, within your scope and payer rules." A warning sign is any target that pushes how often you see clients or when you discharge them. See What Can Therapists Do When Productivity Quotas Conflict With Clinical Judgment?
Schedule and caseload
- Is there a minimum number of sessions or hours per week?
- Who sets my availability, and can I change it without approval?
- Can I pause new clients if I'm full or need a break?
- Are evenings or weekends required?
Pay and money risk
- When am I paid, and for what: sessions delivered, notes completed, or claims collected?
- If a claim is denied or paid late, does that affect my pay?
- What happens when a client no-shows or cancels late? Is there a fee, and who gets it?
- Are there any fees taken from my pay, such as for software or billing?
The question about denials matters more than most people expect. Being paid only when claims are collected moves the payer's delays onto you.
Admin and support
- Who handles credentialing, and how long does it usually take?
- Who handles authorizations, claims, and payer calls?
- Which EHR do I use, and who chose it?
- Who do I contact when something breaks, and how fast do they answer?
- Is there a note deadline, and how is it enforced?
Contract terms
- Am I a W-2 employee or a 1099 contractor? Does the way they manage me match that? The IRS looks at behavioral control, financial control, and the type of relationship.
- Is the contract exclusive? Is there a non-compete or non-solicitation clause?
- Do I need my own malpractice insurance? What limits?
- How much notice do I have to give to leave, and what happens to my clients?
How ValorWell handles this
Here are ValorWell's answers to the questions above:
| Question | ValorWell's answer |
|---|---|
| Clinical decisions | Yours: assessment, diagnosis, modality, frequency, referrals, discharge |
| Declining referrals and age range | You decide clinical fit and your minimum client age, and that decision is final |
| Productivity targets | No arbitrary targets that override clinical judgment |
| Caseload minimum | None imposed; you choose capacity |
| Schedule | You set availability in the EHR and can turn new clients on or off any time |
| Pay timing | Weekly, for sessions documented that pay period |
| Denials | Handled by ValorWell; they don't reduce your pay |
| No-shows | Client is billed a reduced fee where program rules allow, and the full amount goes to you. VA Community Care clients can't be charged, so missed sessions are limited |
| Credentialing, authorizations, billing | Handled by ValorWell |
| EHR | Custom system built with clinician input, with AI-assisted documentation |
| Support | Admin team generally responds within a few hours |
| Note deadline | None official; sessions are paid when the note is completed |
| Employment type | 1099, nonexclusive |
| Malpractice | Your own; ValorWell doesn't provide it |
| Leaving | Any time, with clinically appropriate notice so clients can be transitioned |
Important limits
- A checklist can't replace the contract. Whatever you're told, the signed agreement controls. That applies to ValorWell too.
- Good answers don't guarantee volume. Ask how referrals work in your state, and expect an honest "it varies."
- This isn't legal or tax advice. For non-compete clauses or worker classification questions, a local employment attorney can review the contract.
- Your profession's ethics still apply everywhere. No contract can require you to abandon clients or practice outside your competence.