Private Practice Guides for Therapists

Lost Your CP 575? Get an IRS 147C Letter for Credentialing

Payer asking for your CP 575 and you can’t find it? Call the IRS for Letter 147C. Payers list it as an accepted alternative, and you keep the same EIN.

How to Change EIN With Insurance Companies

Changing your medical practice EIN? Use this Medicare, payer, NPI, credentialing, EDI, and EFT checklist to avoid preventable payment gaps.

How Bomi Improves VOB Accuracy

How Bomi checks benefits, handles uncertain network and cost-share answers, compares VOB estimates with remittances, and improves payer-specific rules.

Why Verification of Benefits Is Often Wrong

Why electronic and phone VOBs can miss deductible, network, authorization, Medicare, and Medicaid details before the first claim is processed.

Telehealth Therapy Coverage: What to Verify With the Plan

Before a video therapy session, confirm the plan’s telehealth benefit for the CPT code and your network status where the client will be. Here is what to check.

EAP Sessions Exhausted: Switching Therapy to Insurance

When a client’s last EAP session is done, close out the EAP, then verify their health plan like a new client: deductible, network and authorization first.

How to Estimate a Therapy Deductible, Copay, or Coinsurance

Estimate a client’s per-session therapy cost before and after the deductible from the plan’s allowed amount, then explain it as an estimate, not a bill.

Mental Health Carve-Out: Find Who Manages the Benefit

A client’s mental-health benefit may be run by a different company than the one on the card. Find that administrator before checking network or claims.

Authorization Units vs Visits: Tracking Therapy Approvals

Read a therapy authorization by its quantity type, codes and date window, count only attended sessions against it, and renew before visits or dates run out.

Therapy Deductible Reset: What to Recheck Each Plan Year

When a client’s plan year turns over, rerun eligibility, update the member ID and plan, and give a fresh estimate before the first new-year session.

Client Met the Out-of-Pocket Max? What to Check

A client who met their out-of-pocket maximum usually owes no more in-network copays this plan year. Verify the limit and date before you stop collecting.

Therapy Referral vs Prior Authorization: The Difference

A referral sends the client to you; a prior authorization approves specific therapy visits in advance. Learn what each one needs and why one is not the other.

Out-of-State BCBS Card: How BlueCard Claims Work

Bill an out-of-state Blue Cross Blue Shield PPO member to your local Blue plan, not the plan on the card. Check the suitcase, prefix and product first.

Insurance Product vs CPT Code: What Is the Difference?

The insurance product is the client’s specific plan or network, like an HMO or PPO; the CPT code is the service you bill. Your biller needs both to answer you.

Medigap Plan G: Why a Therapy Client Owes a Deductible

Standard Medigap Plan G pays the Part B coinsurance but not the Part B deductible, so early-year therapy visits can leave a balance. Here is how to confirm it.

Does Psychological Testing Need Prior Authorization?

Often, yes. A plan can list screenings under preventive care with no authorization while psychological testing needs one. Verify the testing codes themselves.

UnitedHealthcare StudentResources: Therapy Billing Guide

StudentResources is UHC’s school-year student plan. Verify term dates, the clinician’s license and network status, and supervision rules before billing.

Can a Therapy Practice Waive a Copay?

Routinely waiving copays for insured clients creates payer and compliance risk. Individual, documented hardship relief is different. Here is how to set it up.

Bill Under a PLLC or PC, Not Your SSN

Billing insurance under your SSN works at first but quietly creates credentialing and contract problems. A PLLC or PC with its own NPI Type 2 is cleaner.

Illinois HB1806: AI for Notes & Billing

Illinois HB1806 does not ban every AI tool in therapy practices. It separates administrative AI, documentation support, and AI that acts like the therapist.

Start a Therapy Private Practice in Illinois

A 12-week Illinois private practice setup guide for therapists: licensure, PLLC, HIPAA, telehealth, NPI, CAQH, credentialing, and billing.