The Billing Trap That's Costing Therapists Time and Money
Aug 25, 2026When Billing Starts Running Your Practice
Have you ever looked at your calendar and thought,
"I built this practice...but I don't know if I can keep living like this."
That's a hard thought to admit.
Because on paper, everything looks good.
Your schedule is full. Clients are making progress. The practice is growing.
But when the last session ends, another kind of work begins.
- Insurance claims
- Denied payments
- Phone calls
- Progress Notes
Before long, billing has followed you home.
I hear this story from therapists all the time. They don't mind working hard. They mind feeling like they're always working.
That's a different problem.
And it usually isn't about insurance.
The Trap Most Therapists Don't See
Most therapists think the answer is to work a little harder.
Stay an hour later.
Catch up on billing this weekend.
Handle one more thing yourself because no one else will do it quite right.
I get it.
When you're building a practice, doing everything yourself feels responsible.
But this is where we get tricked.
The very things that helped you get started can become the things that keep you stuck.
Insurance billing is one example.
Marketing can be another.
Hiring.
Scheduling.
Even answering every email yourself.
At some point, the question changes from "Can I do this?" to "Should I still be doing this?"
That's an important question because every yes has to come from somewhere.
A Story I Haven't Been Able to Shake
On a recent episode of the Scaling Therapist Podcast, I sat down with Jeremy Zug from Practice Solutions to talk about insurance billing.
Honestly, I expected to learn a few tips about claims and reimbursements.
Instead, Jeremy shared a story that stopped me.
He was reviewing reimbursement rates for a behavioral health organization.
Everything looked normal.
Until he compared what they were being paid with what insurance companies were actually willing to pay.
The difference?
Thirty dollars per session.
Not for a few months.
For twelve years.
No one had told them reimbursement rates had increased.
No one reached out.
They simply kept doing what they had always done.
Jeremy put it this way:
"The insurance companies had been giving raises for years. They just weren't telling anyone."
Think about that.
How many hours did they spend trying to make up that lost income?
How much unnecessary stress came from simply not knowing what questions to ask?
Sometimes the biggest bottleneck isn't working harder.
Sometimes it's not seeing what's right in front of you.
The Line That Made Me Laugh...Then Made Me Think
Jeremy said something I'll probably remember for a long time.
"You're the highest-paid biller in the country."
It's funny because it paints such a clear picture.
If your time is worth hundreds of dollars an hour as a therapist, leader, or practice owner, why are you spending it doing work someone else could do well?
That isn't a criticism.
It's an invitation to look at your calendar differently.
Your calendar tells the truth.
It shows what owns your attention.
And if insurance billing is taking the place of leadership, rest, family, or serving clients, it might be time to ask why.
What Your Calendar Is Really Costing You
Most of us know what software costs.
We know what rent costs.
We know what payroll costs.
But we don't always think about what our own time costs.
If billing takes just five hours every week, that's more than 250 hours in a year.
What could you do with those hours?
Maybe you'd launch that workshop you've been talking about.
Maybe you'd finally create the online course that's been sitting in a notebook.
Maybe you'd invest more time in your team.
Or maybe you'd simply have dinner without thinking about claim denials.
Those things matter.
Because your practice shouldn't cost you your evenings.
The Mistake Almost Everyone Makes
Jeremy shared one more insight that caught me off guard.
The number one insurance claim denial isn't something complicated.
It's duplicate claims.
Most people think the answer is to send claims faster.
Jeremy says the opposite.
Slow down.
Fix the problem.
Then submit a clean claim.
It's simple advice, but it points to something bigger.
Sometimes moving faster creates more work.
Sometimes slowing down is the quickest way forward.
You Don't Have to Figure This Out Alone
One of my favorite parts of hosting the podcast is getting to learn from people who have spent years solving problems most therapists were never trained to solve.
You weren't taught how to negotiate reimbursement rates in graduate school.
You probably didn't take classes on hiring, leadership, or building healthy systems either.
That doesn't mean you're failing.
It means you're doing work that requires new skills.
One thing I've learned after talking with hundreds of therapists is that the bottleneck is rarely what people think it is.
Someone reaches out because they want help with marketing.
But the real issue is capacity.
Another person wants more referrals.
The real issue is that they're carrying too much themselves.
Someone wants to grow.
The real issue is that they're spending their best hours doing work someone else could do.
That's why I love these conversations.
Not because they give us another thing to do.
Because they help us see what we've been missing.
And once you can see the bottleneck, you can start removing it.
Put Your Mission in Motion
Ask yourself one honest question this week.
Am I spending my time growing my practice...or just keeping it running?
If that question hits close to home, you don't have to figure it out alone.
That's why I created the Scaling Therapist Podcast—to have honest conversations that help therapists build practices that serve more people without taking over their lives.
If this article resonated with you, I'd encourage you to listen to the full conversation with Jeremy Zug. Then take a few minutes to explore the other podcast episodes and resources available through Scaling Therapist. You may discover that the challenge you're facing isn't the real bottleneck after all.
And if you'd like someone to help you think through what's keeping your practice stuck, I'd be honored to walk alongside you. (Contact me here.) Whether that's through the podcast, a workshop, or simply starting a conversation, my hope is the same.
To help you build a practice that gives you room to serve well, lead well, and live well.
Because your mission deserves more than whatever time and energy are left at the end of the day.
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