Should a Solo Therapist Outsource Billing? 7 Questions to Ask
Whether to outsource therapy billing comes down to time, cash flow and risk. If claims, denials and payer calls pull you away from clients, or you cannot say how much is unpaid, a billing service may fit. Answer these seven questions honestly before you decide.
How much of your week goes to billing?
Add up the time you spend on claims, eligibility checks, follow-up calls and posting payments. Billing hours are hours you are not seeing clients or resting. A practice that bills well is not always a practice that bills efficiently, and that gap is often what pushes owners to outsource therapy billing. Our billing FAQ answers common questions about handing this work off.
Do you know how much is unpaid, and for how long?
Every claim has a deadline. Payers set their own timely filing limits, and a claim filed too late is usually lost. If you cannot list your unpaid claims by age, you cannot catch the ones about to expire. Many owners outsource therapy billing for exactly this reason.
Who works your denials?
A denied claim does nothing until someone fixes it or appeals it. Decide who owns that work. A billing service handles denied claim follow-up and appeals as part of the job.
Are you in-network or out-of-network?
Out-of-network billing adds steps, from superbills to claim formats. MCM South bills out-of-network claims for clients. Read our guide to in-network vs out-of-network credentialing to see how your status shapes the work.
What happens when you are out?
If you are the only person who bills, a week off can stall your claims. A billing service keeps claims moving while you are away, so ask any service how it covers absences on its end too.
Is patient data protected?
A billing service handles protected health information, so HIPAA requires a written business associate agreement with it. Read the HHS guidance on business associates and ask any service to sign one before it sees a claim. HHS also publishes sample business associate contract provisions.
How will you pay for it?
When you outsource therapy billing, services price in different ways, such as a percentage of what is collected, a flat monthly fee or a per-claim fee. MCM South charges on a percentage basis, and we do not publish the rate here. For how billing services get paid in general, read how medical billing services get paid and how therapists pay their billing service.
Should you outsource therapy billing? What to do with your answers
If you answered “I don’t know” to three or more questions, it is worth a conversation with a billing service. See what billing services for therapists do each month and compare a part-time biller vs billing service first. Look at our billing services and mental health billing for private practice. If you also need insurance panels, our credentialing service covers that step.
Frequently asked questions
What does a billing service cost?
It depends on the pricing model. Common models are a percentage of collections, a flat fee or a per-claim fee. Ask for the model in writing and for a list of what it covers.
Do I lose control of my billing if I outsource?
No. You still approve your fees and your documentation. Ask what reports you will receive so you can see what is billed, paid and outstanding.
Can a billing service handle out-of-network claims?
Some can. MCM South bills out-of-network claims for clients. Always confirm before you sign.
Does outsourcing billing make me HIPAA compliant?
No. You remain responsible for protecting patient information. A business associate agreement defines what the service must do on its side.
Where MCM South Medical Billing Service Works
MCM South Medical Billing Service, LLC works with psychotherapists and psychiatrists in our ten currently served states: Georgia, Massachusetts, Connecticut, Texas, Florida, New York, Colorado, Tennessee, North Carolina and Illinois. We work with solo and medium-size practices.
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