Headway/Rula vs. Independent Private Practice— Let's Talk About It.
Just as a disclaimer, I'm not here to bash Headway or any other Big Therapy Tech companies (i.e. Rula, Alma, Better Help, etc) or give you a comprehensive review of any of these platforms. I just want to provide you with some information so that you can objectively make your own decision.
If you're thinking of using a Big Therapy Tech platform as a part of your private practice, here are a few things you should know:
1. While Headway was previously in network with Kaiser, they are starting to phase out Kaiser since Kaiser decided not to resign their contract with Headway (I'm not sure why). Considering that Kaiser is a very popular insurance plan in Hawaii, this may be a big loss of business for you if you decide to contract with Headway.
2. Rula will provide you with many Kaiser referrals, but they will only reimburse you at $80-$90 per session compared to $130.57 if you're credentialed directly with Kaiser.
3. Therapists I know who use Headway have shared that they haven't noticed any client referrals through Headway, so you will still have to rely on other marketing strategies anyway (i.e. networking, boosting your website, etc).
4. Several Big Therapy Tech companies won't reimburse you if you mention Brainspotting, hypnosis, or other specialized forms of therapy within your progress notes.
They will, however, reimburse you for mindfulness, CBT, and EMDR. Ironically, even insurance plans I've worked with directly aren't nearly this picky about documentation.
5. Headway DOES credential you with HMSA and HMSA Quest,
which are very popular plans here in Hawaii, however...
6. Headway will reimburse you at $106 per 90837 session, yet HMSA will reimburse you at $123.08 per 90837 session if you bill HMSA directly.
That is a $17.08 difference per session (i.e. $123.08-$106). If you're seeing 10-20 (or more) HMSA clients per week in private practice vs. through Headway, this pay difference adds up really quickly. But there's more…
So let's break this down: say you see 10 HMSA PPO clients per week through Headway at $106 per 90837 session. This would equate to $1,060/week, or $4,240/month (assuming there are no vacations, holidays, sick days, or cancellations).
Since you'd have to pay the GE tax of 4.5% on these earnings, you'll end up with $4,049.20 that month instead of $4,240.
How Much Money Are You Losing to Headway in Hawaii? A Therapist's Financial Guide
Now let's say that you see those same 10 HMSA PPO clients per week through your private practice, where you bill HMSA directly and receive $123.08 per 90837 session instead of $106. This would equate to $1,230.80/week, or $4,923.20/month (again, assuming that there are no vacations, holidays, sick days, or cancellations).
You could also charge the GE tax for each of those sessions. Which means you get to keep the 4,923.20 that you earned.
Now let me ask you this—would you rather earn $4,923.20 that month by billing HMSA directly through your private practice, or only $4,049.20 that month by seeing those clients through Headway, which allows Headway to keep that remaining $874 that month that could have been yours?
One year of losing $874/month then equates to a loss of $10,488/year!
And if you see more than 10 HMSA PPO clients per week (which is highly likely), your income loss will be even greater than that.
Again, I'm not here to bash Headway, Rula, or companies like it.
As a business owner, I just always like to look at the numbers to see what makes the most sense.
Personally, I'd rather continue my private practice independent of a Big Therapy Tech company so that I can spend that extra $10,488/year on my children's private school tuition... or maybe even a trip to Disneyworld.
Maybe that’s you, too.
You want the independence of private practice—but the thought of doing insurance credentialing on your own gives you anxiety. The paperwork feels overwhelming, the terminology is confusing, and you’re worried about getting it wrong.
That’s exactly why I created De-Mystifying Insurance Credentialing — a step-by-step course that walks you through the process with clarity and confidence.
In this course, you’ll learn how to:
Complete credentialing applications for major insurance companies in Hawaii, step-by-step
Access direct links and contact information for each insurer (no hunting around online)
Avoid common mistakes that delay approval
Confidently build and manage your private practice without relying on Big Therapy Tech companies
The result?
You keep more of your hard-earned income, serve your ideal clients, and finally feel empowered to run your practice on your terms.
Ready to get started?
→ Enroll in “De-Mystifying Insurance Credentialing” Today
Use code THTH20 at checkout to receive 20% off.
(Imagine what you could do with the $10,000+ per year you’re currently leaving on the table.)
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About Jessica Wong, LCSW
Jessica Wong is a Licensed Clinical Social Worker and the founder of The Hawaii Therapist Hub, LLC and DaVine Counseling Services, LLC. She provides step-by-step support for Hawaii therapists who want to simplify insurance credentialing, billing compliance, and private practice growth. Jessica’s courses and consultations are designed to cut through the confusion so therapists can run their practices with confidence and clarity. Whatever it is, the way you tell your story online can make all the difference.