Your First Hire: When Therapists Should Get Admin or Billing Help
If you're running a private practice and doing everything yourself—scheduling, billing, bookkeeping, emails, marketing —you’re not alone. Most therapists start out solo. But if you’re feeling stretched, behind, or like you’re constantly reacting instead of leading your business… it might be time to get support.
Here’s how to know when it’s time to bring in admin or billing help—and how to make that first hire thoughtfully, even if you’re not sure you’re “ready.”
Why Therapists Wait Too Long to Hire Help
Many therapists hesitate to outsource because:
“I’m not busy enough yet.”
“It only takes a few minutes—I should just do it myself.”
“It’s hard to trust someone else with sensitive tasks.”
“It feels selfish or unnecessary.”
But doing it all yourself comes at a cost: time, burnout, dropped balls, and stalled growth. You didn’t start your practice to spend half your week on admin.
Signs It’s Time to Hire Support
You might be ready for help if:
You're consistently behind on billing, emails, or documentation
You're spending more than 1–2 hours per day on non-clinical tasks
Your income has plateaued because you can’t take on more clients
You’re exhausted by context switching (therapy brain → admin brain)
You avoid or delay tasks that keep your practice running
Even a few hours of support each week can give you back your focus—and your evenings.
What Tasks Should You Hand Off First?
Start with the tasks that are low risk, repeatable, and time-consuming, like:
New client onboarding
Appointment reminders
Insurance verification or claims submissions
Following up on unpaid invoices
Organizing client files
Monitoring voicemails or inboxes
Start small. You don’t need a full-time VA. Just identify the tasks that drain you the most and create a short SOP or Loom video to hand them off.
Admin vs. Billing: What’s the Difference?
Admin support usually includes scheduling, communication, and organization.
Billing support may involve insurance claims, payment reminders, and A/R follow-up.
Some people do both. Some specialize. You can always start with admin and add billing later—or vice versa.
The key is to protect your client time and your CEO time—and let someone else handle the rest.
But What If I’m Not “Big Enough” to Hire?
This is one of the biggest mindset traps.
You don’t need a 6-figure practice or a full caseload to start delegating. In fact, hiring early helps you grow sustainably—because you’re not maxed out when more clients come in.
Think of it like therapy for your business: it’s easier to stay healthy when you’re proactive, not in crisis.
What I See in My Clients
The therapists I work with who hire early—even 3–5 hours a week of help—often report:
More energy and less stress
Clearer systems
Higher client capacity
Improved boundaries
Increased revenue (because they have time to focus on high-value work)
You don’t have to do everything alone. And you don’t have to wait until you’re drowning to ask for help.
Want Help Preparing for Your First Hire?
Whether you're ready now or thinking ahead, I can help you clean up your books, identify the best tasks to delegate, and build simple systems that make outsourcing easier.
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Referral Disclosure
Some links in this post may be referral links, which means I may receive a small commission if you choose to sign up—at no extra cost to you. I only recommend tools I’ve personally used or trust for therapists building sustainable practices.