7 Insurance billing myths that keep therapists from going independent
One of the biggest reasons I find that therapists join, and stay with, large billing platforms is most often fear of billing.
I’ve heard colleagues and billing clients alike say things such as:
“Insurance billing is too complicated.”
“I’m scared about clawbacks! I’ve heard of people losing thousands of dollars.”
“I can’t keep track of where the money is coming and going and I’m worried I’m missing out on money and don’t even know it!”
The truth is billing isn’t always easy, but it’s often much more manageable than people might think. Let’s talk about some of the biggest myths.
The Myths
Myth #1: Billing is Complicated
Reality - Most claims are remarkably routine.
Once you’re credentialed with an insurance company, the majority of the claims involve:
confirming clients’ benefits
submitting claims
tracking payment
addressing occasional denials
That’s it.
Myth #2: One mistake will financially tank your practice
Reality - Everyone makes billing mistakes
The challenge isn’t about avoiding mistakes. It’s about understanding what caused the mistake and how to correct it.
Insurance billing is surprisingly forgiving if you’re paying attention and are timely about corrections once mistakes are caught.
Myth #3: You need a billing company
Reality - Many solo and group practice owners bill themselves
When running a practice, it’s all about deciding how you best want to spend your time. Some solo practitioners would rather work on marketing, so they chose to go out of network. Some group practice owners want to hold a caseload, so they hire a biller or admin to handle billing for them.
There’s no wrong chioce. It’s just about deciding how you’d rather spend your time and money.
Myth #4: Denied claims mean you won’t get paid
Reality - Vast majority of denials are fixable
Incorrect modifiers
Wrong place of service (i.e. 02 vs 10)
Outdated insurance information
These are just some of the most common rejections I find, and all can be corrected and resubmitted for payment
Myth #5: Billing takes hours to complete
Reality - Once you have systems in place, many providers take a relatively small amount of time each week on billing and follow-up
I have developed tracking measures, that for me, sometimes take extra time, but are helpful in having the confidence I know where all the money is going, what’s rejected (when relevant), etc.
What’s the Takeaway?
Billing isn’t for everyone.
Some practice owners genuinely don’t enjoy it and for them, hiring a biller can be an excellent investment.
But that decision should com from an understanding of your options - not from believing insurance billing is impossible to learn.
Whether you ultimately do your own billing or hire someone else, understanding the fundamentals will help you to make better business decisions.