10 New Year Tips: This Year, Get Paid Every Dollar
By Barbara Griswold, LMFT
Note: This article was originally posted on January 2, 2024; it was re-posted on December 12, 2025, with minor edits
Maybe you aren’t one to make a list of New Year’s Resolutions. I’m with you. But this year, how about making one resolution you can keep: to start the new year right when it comes to your business.
If you work with clients that have insurance, you know there is a lot you can’t control. But sometimes our own bad financial habits lead to rejected claims and loss of income.
So, start this new year off right, and resolve to collect every dollar you are owed for insurance clients — or to take steps to help your clients get reimbursed.
1. Ask all your clients about possible changes in insurance coverage. January 1st is the most common time of the year that clients (or their employers) will be switching health plans.
2. But don’t trust clients. I know that sounds harsh, but often clients are not aware of changes in their insurance plan, copayments or deductible, which can mean you may not get paid at all. Ask for a copy of their latest insurance card, front and back, even if your client doesn’t think there have been changes. Clients can take a picture of both sides of their card and email or text it to you, if needed.
3. If you are in-network with the client’s plan, call the plan at the start of the year (be sure to have the client’s date of birth handy). Time consuming? Absolutely. But it is absolutely worth it to avoid costly denials and headaches down the line that can come about if you don’t make this call. You may find the client isn’t covered in the new year. Or you may need to request new treatment authorizations for clients before you see them. You may find their copayment has sharply increased, so you need to collect more at each session. And you need to find out if the client has a deductible, which will mean a sudden stop in health plan payments until it is used up.
4. What if they have a deductible? The deductible is the annual amount that many plans require the client to pay out of pocket before the plan begins to pay. Often thousands of dollars, the deductible restarts each January for most plans (though be sure to ask!). So, if a client has a deductible with a January restart, the first sessions of the year must be paid in full directly to you by the client — the health plan will not cover these. But during the deductible period, be sure to charge your client only your contracted rate with the health plan for each session, not your regular full fee. You will still need to bill the plan, even though they won’t pay and the client is paying you directly — this way, the deductible will be whittled away.
5. What else should you ask when you call? See the worksheet “13 Essential Questions: Checking Coverage” in my book “Navigating the Insurance Maze: The Therapist’s Complete Guide to Working With Insurance, 10th edition” (available at my online store). These questions include asking about copayments, deductibles, claim address for mental health, telehealth coverage, whether the services you are providing and your license are covered, and others you might not have thought to ask. Don’t trust the insurance card, as the info on the card does not have the answers to key questions and the information there may not even apply to mental health.
6. Submit your claims early in January, and encourage out-of-network clients to submit superbills quickly. Claims and superbills for January should be submitted after the client’s first session so that you can find out as soon as possible about the new year’s eligibility and any coverage changes and problems.
7. Review client balances from last year. Did you bill insurance for each session from last year, and have you been paid for each visit, by both the client and health plan?
8. Set a new, stricter claim submission routine for the coming year, and add reminders to your calendar so it becomes a lovely new habit. While daily or weekly claim submission is the best, my habit was to submit for two weeks at a time — on the 16th of the month for sessions between the 1st to the 15th of the month, and at the end of the month for the 16th to month’s end.
9. Vow that in the coming year you REALLY enforce your missed session policy. I’m going to bet that you have a clear policy on charging for missed sessions that is outlined in your informed consent. I’m also going to bet that you all-too-often waive this charge, and don’t charge for missed sessions as often as you say you will in that policy. This leads to thousands of dollars in lost income each year. Start a new pattern in the new year (read my article on this topic).
10. Go over the list of insurance plans you work with. Carefully consider if it makes good financial sense for you to continue with each plan in the coming year. Consider asking for a reimbursement rate increase from all plans (read my article on raises).
Barbara Griswold, LMFT is a private practice coach and the author of Navigating the Insurance Maze:The Therapist’s Complete Guide to Working With Insurance — And Whether You Should, 10th edition. Check out Barbara’s online catalog of helpful online courses, practice forms, and other therapist resources related to insurance, documentation, and running your therapy business here, and subscribe to her free e-newsletter here.