Headway or your own insurance contracts? What I'd tell a therapist before choosing
By Kay Ward, founder of Lanyard Health
Short answer: Headway credentials you under its own group contracts, sets the rate it pays you and bills your claims, with no fee to you. Going direct means your practice signs its own contract with each payer and runs its own billing. You keep those contracts if you ever leave a platform. If you plan to hire clinicians or build a group practice, I'd go direct.
I've done credentialing for 15 years. A therapist who asks me whether to join Headway or go direct gets one question back: who do you want holding the contract?
How does Headway work for therapists?
Headway credentials you with insurance plans under its own contracts. You keep your own NPI and CAQH profile, but the in-network spot belongs to Headway (TheraProfessional). Headway bills the payer and pays you by direct deposit. You don't pay a fee to join (ChoosingTherapy). Headway earns the difference between what the insurer pays it and what it pays you (Single Aim Health).
What changes when you go direct?
You apply to each payer (or a credentialing company applies for you), and the contract carries your practice's name and tax ID. The payer pays your practice. You'll need your own billing, through an EHR that sends claims or a biller.
Plan on four to six months from application to approval for most payers. After approval, you set up direct deposit, payment statements and a claims connection with each payer, which takes about 30 more days. I wrote about that stretch in Approved isn't paid.
Headway vs. going direct, side by side
Headway | Your own contracts | |
|---|---|---|
Whose contract | Headway's | Your practice's |
Who sets your rate | Headway | The payer (you can ask to negotiate) |
Who bills claims | Headway | Your practice or your biller |
Cost to you | No fee; Headway keeps part of what the payer pays | Your credentialing and billing costs |
If you leave | The contracts stay with Headway | The contracts stay with you |
Who each one fits
Headway fits a solo therapist who wants to start seeing insurance clients soon and doesn't want to run billing. It also works for someone testing whether insurance work suits them.
Going direct fits a practice that plans to hire or wants its contracts to belong to the business. It's also the way off Headway for a therapist who doesn't want to lose insurance clients.
Can I stay on Headway while I apply directly?
Yes. Start your own applications while you're still active on Headway, and time your exit for the day your direct contracts go live (TheraProfessional). That way you can keep billing insurance through the switch.
Questions therapists ask me
Do my Headway contracts transfer if I leave?
No. The contracts belong to Headway and stay with it. You apply to each payer on your own, so start before you go.
Is Headway free for therapists?
You don't pay a fee. Headway earns the difference between the rate it gets from the insurer and the rate it pays you.
Can Headway change my rate?
Yes, since Headway sets it. With a direct contract, rate changes come from the payer and your contract terms.
Does Headway pay more than a direct contract?
It depends on the payer. One comparison found Headway paid more for Aetna and Cigna and less for Blue Cross Blue Shield and Optum, with the averages about even (Single Aim Health).
Does Lanyard do billing?
No. We handle credentialing and payer enrollment, and we stay on each provider until the first payment arrives. You'll need a biller or an EHR that sends claims.