Headway vs Alma vs Your Own Insurance Billing

Mukesh MakwanaFounder & CEO · Hands-on medical billing & RCM across 11 specialties · Reviewed October 11, 2026

Headway and Alma both let a therapist take insurance without running a billing operation: each one credentials you through its own payer relationships, submits your claims and pays you on a schedule. Billing insurance under your own contracts is the third option: you hold the payer agreements, and you or a billing company do the claim work. The right choice depends on who you want to own the payer contract, which plans you need, and how you want to be paid. This guide lays out what each company says about itself, side by side, using only Headway's and Alma's own published pages.

The three models at a glance

The rows are explained below, with the source for each statement.

Headway, in its own words

• Credentialing: Headway's help center says that once you complete its intake form, it starts getting you credentialed with all of its insurance partners in your region, and that it can help providers get credentialed with multiple nationwide insurance companies in as few as 30 days. Providers licensed in several states can apply in each of them.
• Plans: Headway's client help page lists Aetna, Blue Cross and Blue Shield (in select states), Cigna, Oscar, Oxford, United Healthcare and all Optum affiliates. It says Headway accepts select Medicare Advantage plans nationally and select Medicaid managed care plans in some states.
• Rates: your rates are shown in the provider portal by carrier and CPT code. Headway says it negotiates contracts with health plans, then determines how much it is able to keep on each session, if anything, and that it keeps a small percentage of session payments to support its operations. That amount varies across health plans and billing codes.
• Payment: Headway pays providers twice a month, on the 15th and on the last day of the month, for sessions you confirm. It says it pays providers on time whether or not it has been reimbursed by the insurance company.
• Out of network and private pay: Headway says it does not work with out-of-network benefits. It offers two options for clients who are not using insurance: private pay on Headway, or bill elsewhere, where you bill off the platform yourself. Clients with Medicare or Medicaid policies are not eligible for those two options through Headway.
• Software: Headway lists a provider portal with an EHR included among its group practice benefits.
• Leaving: solo providers can deactivate their account from account settings. Headway says clients you bring to Headway are yours and you are welcome to take them with you, and that its expectation is that clients who find you on Headway in their search for care will continue to be seen on Headway. It suggests downloading any notes stored on Headway before you terminate your account.

Alma, in its own words

• Credentialing: Alma says its credentialing process enables members to be in network with insurance payers and grants access to enhanced rates under Alma's tax ID. Its insurance page states that members need to be credentialed under Alma's Tax ID, regardless of their current individual credential status.
• Payers: Alma's help center says it actively credentials providers with Aetna, Anthem Blue Cross Blue Shield plans in listed states, Carelon, Cigna and Optum. To be paid through its insurance program you must be licensed in the state where you provide the service and credentialed through Alma with each payer.
• Plan scope: Alma describes its program as working with commercial insurance companies. Its plan list names Optum Medicare or Medicaid plans, and Aetna Medicare and Medicaid plans, among the plans it does not accept.
• Cost: Alma says it charges a monthly fee for membership that gives you access to all of its benefits. See Alma's site for the current price.
• Payment: Alma's insurance page says you can choose a weekly or bi-weekly payout schedule. Its billing guide says that after you submit a session, Alma submits the claim to the insurance company and pays the provider for the session.
• Client invoices: Alma invoices insurance clients for copays and coinsurance. Its billing guide says clients with a copay typically receive an invoice shortly after the session, and clients with coinsurance after the insurance company processes the claim.
• Cash-pay clients: Alma says it does not take a cut of fees from cash-pay clients, and that this income stays with you.

Billing insurance under your own contracts

The third model has no platform between you and the payer. You apply to each payer yourself, the contract is in your name or your group's, and claims go out under your own NPI and Tax ID.

• You choose the payers. Any plan that will contract with you, including Medicare and your state's Medicaid program where you qualify. Our guide to getting credentialed with insurance companies covers the steps, and how long credentialing takes covers the timeline.
• The contract stays with you. If you change software, change billing companies or grow into a group, your payer agreements do not move.
• You see the whole claim. You receive the payer's remittance for every session and can see the allowed amount, the patient share and any adjustment.
• Someone has to do the work. Eligibility checks, claims, rejections, denials, payment posting and patient statements are yours, or your billing company's. Payment arrives when each payer pays.

This is the model Sterling Global Solution LLC supports. We handle credentialing for therapists and then do the billing inside the system you already use, including SimplePractice and TherapyNotes.

Questions to ask before you choose

• Whose contract is it? Ask whether you will be in network in your own name or only through the company, and what happens to your network status if you leave.
• Which plans do your clients actually have? Compare each company's plan list for your state with the insurance your current and likely clients carry, including Medicare and Medicaid.
• What will you be paid per session? Ask for the rate by payer and code that applies to your license type, then compare it with what the payer would pay you directly.
• What does the agreement say? Read the provider agreement for notice periods, records access and any terms about seeing the same clients elsewhere.
• How much administration do you want? A platform removes claim work. Your own contracts remove the middle layer and add the work, unless a billing company does it.

How Sterling Global Solution LLC fits

We do not replace Headway or Alma, and we have no relationship with either. We work for therapists and group practices that want their own payer contracts and do not want to do the billing themselves. We get you credentialed, verify benefits before sessions, file and follow claims, work denials and post payments, all in your own account. New billing clients get free credentialing for 3 insurance payers. Start with our 30-Day Free Trial.

Headway and Alma are trademarks of their owners. Sterling Global Solution LLC is an independent billing company. It is not affiliated with, endorsed by or a partner of Headway or Alma. This page summarizes what each company published on October 11, 2026. Terms, plans and prices change, so confirm current details with each company before you decide.

Frequently asked questions

Sources

Headway Help Center, Credentialing with Headway: intake, insurance partners, timing and multi-state credentialing.
Headway Help Center, Using insurance on Headway: accepted plans, Medicare Advantage and Medicaid, out-of-network benefits.
Headway Help Center, Rates and agreements and Getting paid: how rates are determined, the share Headway keeps, and the payment schedule.
Headway Help Center, Private pay and bill elsewhere, Managing your account and How group practices work on Headway.
Alma Help Center, Get Credentialed with Alma's Insurance Program and Insurance Plans Available Through Alma.
Alma, Insurance Program for Therapists: Tax ID requirement, payout schedule, membership fee and cash-pay clients.
Alma Help Center, How Billing Works at Alma: From Claim to Invoice.

This is a factual summary of each company's own published pages, not a recommendation or a review. CPT® is a registered trademark of the American Medical Association. How we verify this guidance.

Related reading

• Credentialing services for therapists. Getting in network under your own name.
• How long credentialing takes. The timeline payer by payer.
• Behavioral health billing. Our full approach for therapy practices.
• SimplePractice billing services. Billing done inside your own account.