Tired of Billing Hassles? Consider a Billing Service

billing hasslesHere’s an option if you feel you are spending too much time dealing with insurance-related paperwork and follow up phone calls: Hire a billing service.

Even if you don’t deal with insurance plans at all, you might choose a billing service to help you deal with outstanding balances from private pay clients.

Not to be confused with a billing software program or an online clearinghouse, a billing service is a live human being (or group of human beings) that you hire to handle your insurance claims submissions or client billing for you.

How does it work?

Each billing service works a bit differently, but typically when you get a new client, you would fax, mail, or e-mail the client data to the billing service. Then, at regular intervals, you would provide the service with a list of clients seen, date seen, and procedure codes since last billing. If you are a network provider, the billing service would format and transmit the claims, and send them – usually electronically – to the insurance company. If you are out of network, the service could bill clients for any owed amounts, and provide invoices for clients to give to their health plans for reimbursement.

What else can a billing service do for you?

For an additional fee, most billing services will provide a host of services, including verifying insurance coverage for new clients, following up on lost or unpaid claims, keeping track of unpaid client balances, tracking authorizations, and assisting with plan applications/recredentialing.

What’s the payoff?

Therapists like Karen Rose, MFT, report that hiring a billing service has been the key to their sanity. “They do all the paperwork for my practice, including billing, tracking claims, dealing with unpaid claims, credentialing and re-credentialing. In fact, I now print on the back of my business cards, ‘For billing questions, contact…’ with their phone number. In this way, my clients contact them directly regarding billing and insurance issues, and I can just focus on doing therapy.” She says “I’d rather spend an extra hour or two doing therapy each month to pay for my billing service than to spend those hours dealing with paperwork and billing headaches.”

Says K’Alisa Rowan, MFT, “I could bill electronically myself with the touch of a few buttons. But what I love is having my billing service do all the prep and follow-up. It’s verifying benefits and chasing down missed payments that I dislike. They are so time-consuming.”

Yes, but what is this going to cost me?

Financial arrangements vary: Billing services may offer flat-fee pricing (a set amount per month regardless of number of claims filed), per-claim fees, per hour charges, a percentage based on the dollar amount of claims filed or reimbursements received, or some mixture of the above. And your fee will be based on how much you have them do for you.

Any recommendations when it comes to choosing a billing service?

  • Find a service that specializes in mental health billing, which can be quite different than medical billing.
  • Find someone who stays on top of the ever-changing world of mental health insurance coding and billing.
  • Find someone who has extensive experience working with other therapists and insurance plans in your state.
  • Consider carefully what it is that you want a billing service to do for you, and shop around, getting estimates from different services.
  • Write out and sign clear agreements about all expectations and fees.
  • Interview billers and call their references.
  • You need not find someone with an office close to you; it is possible that all communication may take place via phone, fax, or e-mail.
  • Most importantly, monitor them closely – ask for regular reports on which plans have been billed for what clients and what dates of services, so if something happens with the billing service you could pick up where they left off.

Where do I find such a service?

Because I get this question a lot, I have surveyed therapists and billing service owners and put together a Mental Health Billing Service Referral List. The list of over 30 billing services comes complete with details about their services and fees to make quick comparison possible. It also has a suggested list of questions to ask a service before you hire them, and even therapist reviews. I hope this will provide a place to start. Get yours now on my “Order” page.

One final thought: Remember that if a service is submitting electronically on your behalf, you become a HIPAA “covered entity,” and need to comply with HIPAA.

Image courtesy of ddpavumba at

Tired of Billing Hassles? Consider a Billing Service

Barbara Griswold, LMFT

Barbara Griswold, LMFT, is a licensed marriage and family therapist and insurance consultant. She is the author of Navigating the Insurance Maze: The Therapist's Complete Guide to Working With Insurance – And Whether You Should. Barbara offers workshops, webinars, and consulting services on insurance, billing, and coding to therapists. She can be found at and [email protected]


APA Reference
Griswold, B. (2019). Tired of Billing Hassles? Consider a Billing Service. Psych Central. Retrieved on May 28, 2020, from


Scientifically Reviewed
Last updated: 20 Mar 2019
Last reviewed: By John M. Grohol, Psy.D. on 20 Mar 2019
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