Do I Need a Billing Service or Can I DIY? A Therapist’s Guide to Handling Insurance Like a Boss
Starting your own therapy private practice comes with a ton of decisions—what to charge, which EHR to use, how to find clients, and oh yeah… how to get paid. One of the first big questions many new private practice therapists ask is:
“Do I need a billing service, or can I do my own insurance billing?”
Let’s break it down.
The Billing Service Temptation
Billing services are kind of like a personal assistant for your claims. They handle the submission, track denials, and sometimes even follow up with insurance companies. Sounds dreamy, right?
But here’s the catch: most billing services charge 6% to 10% of your income, every single month. That’s hundreds—if not thousands—of dollars a year. And unless you’re bringing in big numbers or completely drowning in admin tasks, that’s a lot of money for something you can learn to do yourself.
There’s also this not-so-fun reality: when someone else is in charge of your billing, you might not really understand how your money flows. You could miss important errors, leave money on the table, or struggle to untangle things when you eventually want to switch services or go solo.
Why I Recommend Solo Practitioners DIY Their Billing
If you’re a solo therapist (or planning to be one), I genuinely believe you’re better off learning to handle your own insurance billing—at least at the beginning.
Here’s why:
1. You Understand Where Every Dollar Comes From
Knowing how claims work helps you understand what you’re actually getting paid for, how long payments take, what to expect from different insurance companies, and how to troubleshoot when things go wrong. That kind of knowledge = power.
2. You Catch Errors Faster
Billing errors happen all the time. If you outsource, you might not notice until months later when your income’s lower than expected. Doing it yourself means you're in control and can correct issues quickly.
3. You Avoid Ongoing Fees
Let’s say you earn $80K a year. A billing service charging 7% would cost you $5,600 annually. You could invest that in better systems, clinical training, or more vacation days. Just saying.
4. It’s Not as Hard as It Sounds (Promise)
This is the part where most therapists go, “But insurance is confusing and I’m bad at numbers!” Deep breath. It’s totally learnable—especially with the right tools.
Tools That Make DIY Billing Actually Doable
One of the biggest reasons therapists shy away from handling their own billing is that it sounds like a full-time job. But with the right electronic health record (EHR) system, it doesn’t have to be.
A good EHR can take most of the stress out of billing by offering:
Claim generation with a click – No forms to manually fill out every time.
Built-in insurance tracking – So you always know what’s paid and what’s pending.
Payment reports – So you can spot trends, errors, and slow payers fast.
Client insurance info stored securely – So you're not chasing paperwork.
Many modern EHRs also let you automate recurring tasks, like sending superbills or verifying benefits, which saves you even more time.
Personally, I recommend Sessions Health for solo and small-group therapists. It’s built specifically for mental health providers, is very beginner-friendly, and offers intuitive billing tools without a huge learning curve. Use my Sessions Health Referral Link to get a free trial, and once your trial ends and you pay your first invoice, you will receive a credit for one month of the base subscription fee.
Bottom line: you don’t need to be a tech wizard—or an accountant—to handle your own billing if your EHR is doing the heavy lifting.
When a Billing Service Might Make Sense
Okay, let’s be fair. There are times when a billing service could be helpful:
You’re in a large group practice and billing hundreds of claims a month.
You’ve tried DIY and it’s truly draining your energy and joy.
You have complex billing needs (like out-of-network benefits, multiple clinicians, etc.).
Even then, I’d argue you should understand the basics first—so you can monitor your income, ask smart questions, and advocate for yourself.
TL;DR: DIY First. Outsource Later (If You Want).
You don’t need a billing service to run a successful private practice. With a little guidance, the right tools, and a willingness to learn, you can take charge of your income and avoid unnecessary fees and confusion.
And if you ever do decide to outsource down the line, you’ll do it from a place of knowledge—not desperation.
Want Help Setting Up Your Billing System?
If you’re a therapist ready to learn how to manage your insurance billing with confidence, I’d love to help.
I offer personalized consultations to walk you through:
How to use Sessions Health for billing
What you need to know about insurance claims
Common pitfalls to avoid
How to feel calm and in control of your income
Click here to schedule a consultation with me today. Let’s make billing one less thing to stress about.
Related Articles: Should You Take Insurance in Private Practice? The Pros and Cons
