197. What Do Practice Owners Need to Know About Billing to Be Successful? — Private Practice Elevation with Daniel Fava

Is it possible to grow a thriving therapy practice while taking insurance?

If you've ever wondered whether insurance billing is worth the headache, or how to do it right, this episode is for you.

Today's guest, Jeremy Zug, co-founder of Practice Solutions, breaks down what private practice owners need to know about billing in order to be successful.

With over a decade in the healthcare industry and a team that manages billing for thousands of providers, Jeremy brings clarity and strategy to a topic that overwhelms a lot of therapists.

Whether you're solo and private pay or growing a group practice, you'll walk away with fresh insights, helpful mindset shifts, and even a few small changes that could dramatically improve your revenue.

This episode answers... 1. Do I need to take insurance to grow my therapy practice?

Not necessarily — but if you do, it needs to be intentional. Jeremy shares that some of the most successful practices limit themselves to one commercial payer and one government payer (like Medicaid or Medicare). This approach reduces administrative overwhelm and allows you to stay aligned with your clinical mission.

Trying to accept every insurance plan in your area can actually slow your growth, especially as your practice scales. Instead, focus on which payers make the most sense based on your long-term goals, who you serve, and what the reimbursement rates look like in your region.

Insurance can absolutely support practice growth, especially when it's chosen strategically.

2. When should I outsource my billing — and when should I bring it back in-house?

Outsourcing makes the most sense when your caseload is full. That's usually around 25 to 30 active clients. At that point, billing becomes a time-consuming task that pulls you away from clinical work or team leadership. Jeremy recommends outsourcing to save time and reduce stress, which ultimately helps you grow faster.

But once your practice reaches about $2.5 to $3 million in revenue, it may be time to bring billing back in-house with a full-time hire. At that stage, having someone on your team who's dedicated to billing can help you scale more efficiently.

It's not a one-time decision. It's about matching your billing approach to your practice's size and complexity.

3. How can I improve my billing process and increase revenue?

Even small tweaks to your billing workflow can make a big difference. Jeremy explains how simply reordering certain steps, like reviewing payment posting before resubmitting claims, can dramatically reduce denials and speed up revenue.

Many practices waste time by resubmitting the same flawed claims without resolving the underlying issue. He also stresses the importance of reviewing your insurance aging report regularly, which shows you what claims are still unpaid and where you might be losing money. Billing isn't just about submitting claims; it's about building a system that supports healthy cash flow.

The more visibility and control you have over your billing process, the more financially stable your practice becomes.

In This Episode, You'll Also Learn:

Why less is more when it comes to insurance plans
How your geography and demographics should shape your billing strategy
The six key steps of billing, and which one to do before submitting claims
When to outsource billing (and when to take it back in-house)
How to use insurance aging reports to track lost revenue
Why clean billing processes can boost staff retention
The right way to negotiate insurance rates using data
Real examples of practices recovering thousands of dollars

Links mentioned in this episode:

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This Episode Is Brought To You By:

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Alma is on a mission to simplify access to high-quality, affordable mental health care by giving providers the tools they need to build thriving in-network private practices. When providers join Alma, they gain access to insurance support, teletherapy software, client referrals, automated billing and scheduling tools, and a vibrant community of clinicians who come together for education, training, and events.

Learn more about building a thriving private practice with Alma at helloalma.com/elevation.

About Jeremy Zug

Jeremy Zug has over a decade of experienc