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A provider-side comparison of Alma, Headway, Grow Therapy and Rula in 2026: fee models, rate transparency, who owns your payer contracts, and how each compares to contracting directly.

Aetna's reimbursement changes for therapists credentialed through Alma took effect on July 15, 2026, as scheduled. If you are a solo therapist, psychologist, LCSW, LPC, or LMFT using Alma to bill Aetna, the rate changes are no longer something to prepare for they're now live on your claims. Here's exactly what changed, what happened between the announcement and the effective date, and what your options look like now. On May 20, 2026, Alma notified its providers that Aetna wo

By Danielle Wagar, CPES | Upstate Healthcare Admin You typed it into Google at 11pm after a particularly frustrating day. "Can I leave Headway?" Maybe your reimbursement rates feel insulting for the level of care you provide. Maybe you are tired of being locked out of your own billing data. Maybe a client mentioned they found you through the directory and you realized, with a sinking feeling, that you have been building someone else's referral network for free. Whatever broug

Headway is adding a $9.99 per-session marketplace fee. See what it costs and how to credential directly with insurers without a coverage gap.

Submitting a credentialing application is only the beginning. Learn what to track, when to follow up, how to catch deficiencies, and why confirming the provider’s effective date is essential before considering the process complete.

It is one of the most frustrating dilemmas in practice management: you have hired a brilliant new clinician, their schedule is filling up, but their insurance credentialing applications are sitting in payer limbo. The temptation to start billing immediately—or find creative ways to process claims—is massive. However, submitting claims prematurely can lead to immediate denials, clawbacks during audits, and potential compliance violations under the False Claims Act if improperl

Walking through your clinic and seeing every exam room occupied feels like success. Your providers are working at capacity, patient volume is high, and demand has never been stronger. Yet, when you look at your bank account at the end of the month, the numbers tell a completely different story. If your schedule is packed but your practice is struggling with inconsistent collections, you are experiencing the Volume-to-Revenue Disconnect. High patient volume does not guarantee

Bringing a new provider onboard is an exciting milestone for any healthcare practice, but nothing halts momentum faster than billing bottlenecks. From delayed claims to outright denials, failing to complete every step of provider credentialing can freeze your revenue pipeline before it even starts. To keep your operations running smoothly and ensure every service rendered is reimbursable, follow this step-by-step readiness checklist before your new clinician sees their first

Managing practice revenue requires understanding where every claim sits in the insurance pipeline. A claim is not simply "submitted" or "paid." It moves through distinct status stages, and misinterpreting these statuses can stall cash flow or hide severe revenue leaks. Here is a breakdown of the six core stages of the insurance claim lifecycle, what each status means for your practice, and how to handle them effectively. 1. The Pre-Adjudication Stage: Accepted vs. Rejected Be

Few administrative hurdles cause more delayed payments, claim rejections, and head-scratching than provider credentialing and enrollment. When setting up or expanding a healthcare practice, one of the earliest structural decisions you’ll face is determining whether to pursue Individual Credentialing or Group Credentialing. Picking the wrong pathway doesn't just mean extra paperwork—it can stall your billing for months, leave rendering providers out-of-network, or trigger imme

If you look strictly at the headline conversion factor, Medicare PT/OT Fee Schedule reimbursement for physical and occupational therapy appears to have received a welcome boost for 2026. However, the actual impact on your clinic's bottom line is more nuanced. While the baseline conversion factor rose by over 3%, a new permanent 2.5% efficiency adjustment applied to non-time-based work Relative Value Units (RVUs) offsets those gains for certain services. Depending on your cli

Remote Therapeutic Monitoring (RTM) is the use of medical devices to collect non-physiological data, such as therapy adherence and pain levels, from patients at home. Despite its potential, many practices have resisted launching RTM programs, citing rigid rules that often resulted in significant clinical effort going unreimbursed. What changed with RTM billing in 2026? Beginning January 1, 2026, new RTM CPT codes allow PT and OT practices to bill certain Remote Therapeutic Mo

When a practice upgrades its clinical workflow say, moving from a platform like TherapyNotes to a system like Jane, backed by a clearinghouse like ClaimMD there is usually a lot of excitement. You look forward to cleaner interfaces, better scheduling, and fresh features. You check the boxes to link your new clearinghouse, hit submit on a few test claims, see them go through successfully, and assume the transition is complete. Then, two weeks pass. You know you’ve had claims p

It’s a scenario that makes every private practice owner’s stomach drop. You pull your weekly remittance advice, expecting a healthy reimbursement for a complex patient session where you billed multiple units or multiple distinct codes. Instead, the payment that hits your account is a fraction of what you calculated. Your first instinct? Call it an underpayment, blame a payer glitch, and gear up for a timely filing appeal. But before you spend hours on hold or drafting appeal

If you have been wondering whether Medicare still reimburses virtual therapy visits, the direct answer is yes. Physical therapists (PTs), occupational therapists (OTs), speech-language pathologists (SLPs), and audiologists remain fully eligible to bill Medicare for Telehealth services through December 31, 2027. While political debates and temporary funding fights caused confusion early in the year, Congress officially resolved the status of therapy Telehealth. Here is what ha

Is your practice invisible online? Learn why your Google Business Profile views matter for growth and get 4 simple fixes to boost local search rank

It is one of the most frustrating notifications a private practice owner can receive. You submit a clean batch of claims, wait weeks for reimbursement, and instead open a Remittance Advice marked with a rejection code: Denied for Incorrect NPI. This specific rejection is incredibly common, yet completely avoidable. The most frustrating part is that an incorrect NPI claim denial often has absolutely nothing to do with you doing anything wrong clinically. Your NPI is real, your

It is the silent cash flow leak that every private practice owner deals with. You look at your schedule for the day, see a full lineup of five or six sessions, and plan your business revenue accordingly. Then, at 10:00 AM, a text arrives: "So sorry, something came up and I can't make it today." Two hours later, another client simply fails to log into the telehealth portal or show up at your office. Most therapists accept cancellations and no-shows as an inevitable, frustratin

When you first opened your private practice, your main goal was likely filling your schedule. To make that happen, you probably joined every insurance panel available in your area. Most therapists treat their panel list as a permanent setup: they take whatever insurance walks in the door and rarely look at their insurance contracts as a strategic business lever. But as your practice grows, taking every plan without a clear strategy can quietly cap your income. If you are work

It is a moment of total panic. You log into your billing portal or open the mail to find a notice from an insurance company stating you have been overpaid. They want their money back. To make matters worse, the notice is for claims you successfully processed and closed a year or more ago. If your stomach drops when you see these letters, you are not alone. This is happening constantly right now. Insurance audits and retrospective demands are skyrocketing across the mental hea