Be Successful in Private Practice

Let’s Settle the Debate

If you’re a therapist looking for an easy way to add a few insurance clients to your practice, or a therapist starting a private practice for the first time, you’re probably hearing a lot about Alma and Headway. Let’s talk about the two of them and what the pros and cons are of each one so that you can make the best choice for you.

I started with Headway in 2019 when they were a startup in New York City. I joined Alma when they came on the scene in 2020. I’ve watched both platforms go through growing pains and mission changes in the process of finding their place in the ever shifting therapy market.

My experience with them is that they are both great! I appreciated that they allowed me to add a small amount of insurance clients to my existing cash pay practice. For me, this created more stability in my practice. Knowing a paycheck is going to drop into my checking account every week is reassuring. For my clients, it allows them access to high quality in network mental health care.

I like to think about Alma and Headway as practice partners. They are platforms that help private practice therapists get credentialed with and bill insurance. They collect the copays, deal with the insurance companies and negotiate higher rates for their providers. They even bring in client referrals. In essence, they make it easy for solo practitioners to accept insurance by taking care of the hard parts.They do all of this for either a small monthly fee, or per session fee.

Headway and Alma are far from perfect and you will run into issues that just come with accepting insurance. Clients’ copays and deductibles may change without your or their knowledge, coverage can sometimes be denied, and records may be requested (rarely, but it can happen). This is going to happen if you are accepting insurance. It is not the platform’s fault, it is the nature of working with insurance.  But most of the time, things run smoothly, clients workout nicely, and the paychecks come on time. 

Let’s start with an overview of what both platforms offer in chart form, and then at the end, I’ll give you my personal advice. 

Headway vs. Alma: Therapist Billing Platform Comparison

Feature	Headway	Alma
Cost to Therapists	Free to use; takes a small cut of each payment	$125/month or $1,140/year; also takes a cut
Payment Schedule	Bi-weekly (15th & 30th)	Pays weekly for the week prior
Credentialing Time	30–120 days	Up to 45 days
Multi-State Billing	Yes	Yes
Telehealth Integration	No	Yes
Insurance Accepted	Most major insurers (excluding Medicare/Medicaid)	Most major insurers; also accepts out-of-pocket clients
Referral System	Limited; not a primary focus	Active client matching directory
Reimbursement Rates	Higher than most, generally lower than Alma; varies by insurer	Higher; around $100/session on average
Provider Network Size	Over 10,000 providers	Over 22,000 providers
Therapist Community	Not a focus	Provides opportunities to network and learn from other therapists
Easy of Use	Easier to learn how to use	More complicated to learn initially, but better features
Other benefits	Does not include CEU’s	Includes CEU’s and trainings

What do I recommend? 

It all depends on what your goals are!

If you are new to private practice, you already have a few people and you are just looking for a place to bill insurance, I’d probably start with Headway because it’s free and easy to use. 
If you are looking to build a bigger practice, you want to bring a lot of clients and mostly accept insurance, I’d go with Alma. Alma charges a fee, but they pay is generally higher per session. Also, Alma offers more marketing opportunities including google ads and an integration that allows clients to book through.