Should You Stay Cash Only or Accept Insurance?

Why Partnering With Bridgeway Pays Off In-Network and Out-of-Network

Most families choose providers they can afford and understand. That usually means using their insurance when possible, and getting clear answers about coverage and bills. Bridgeway turns that reality into reliable revenue for your program by submitting clean claims fast, fixing issues before they snowball, and being accessible to families who have questions.

In-network expands access, which grows completed care

Cost is one of the top reasons people skip or delay treatment. In a 2025 KFF survey, 36% of U.S. adults reported postponing or skipping needed care because of cost. When out-of-pocket costs drop with in-network benefits, more people start and stay in care. Link

In psychotherapy specifically, research shows in-network prices and patient cost sharing went down from 2007 to 2017, while out-of-network prices and cost sharing went up. Utilization growth came from in-network visits. Link

How Bridgeway helps that translate into revenue: We submit quickly and accurately so first-pass payments improve, and we work denials fast when they occur. That turns higher in-network volume into higher net collections without adding work to your clinical teams.

Out-of-network can still pay, when handled well

Many employer plans still include out-of-network benefits. PPOs remain the most common plan type for covered workers, which often means members have some out-of-network coverage to activate. Link

When the No Surprises Act applies, there is a formal negotiation and independent dispute resolution process. Provider win rates in federal IDR rose from 68% in early 2023 to about 85% in early 2024. Skilled preparation and documentation matter. Link

Outside those situations, health plans and Medicaid programs can use Single Case Agreements to authorize care with out-of-network specialists when appropriate. Link

How Bridgeway helps out-of-network cases: Our experienced, in-house billers prepare and pursue out-of-network claims, negotiate when appropriate, track timelines, and communicate with families so they can use the benefits they have while you receive fair payment.

Why speed and accuracy change outcomes

Across medical groups, denial pressure has been rising, and many denials are avoidable errors or fixable issues. Link

When denials do occur, appeals often succeed. In Medicare Advantage, plans overturned about 75% of their own denials when beneficiaries or providers appealed. In the ACA marketplaces, fewer than 1% of denied in-network claims were appealed in 2023, which shows how much revenue is left on the table when no one follows through. Link

Bridgeway’s difference: We do not outsource. Your claims are handled by seasoned billers who know payer rules, code correctly, and submit quickly. If a claim denies, we explain next steps to families, correct what is needed, and move it forward. That combination of speed, accuracy, and people-to-people support raises first-pass payments and reduces write-offs.

Families also need a human guide

Provider directories and coverage rules are confusing. Many plan directories contain inaccuracies, which makes it harder for families to navigate care. Having a team that will pick up the phone and answer billing and benefits questions reduces confusion and improves show-up and retention. Link

Real people. Real answers. Less confusion for families.

What you get with Bridgeway

• Fast submissions that reduce timely-filing and first-pass denials.

• Fewer errors through meticulous coding and documentation.

• No outsourcing so accountability is clear and communication is quick.

• Experienced billers who know behavioral health and payer quirks.

• Family support that answers real billing and benefits questions.

Let’s talk about your mix. Whether your patients are in-network, out-of-network, or a blend, we help them use their benefits and help you turn care delivered into dollars collected. Contact info@bridgewaybilling.net.

Sources

• KFF Health Costs Poll, May–July 2025, cost-related care avoidance. KFF+1

• Health Affairs 2020, psychotherapy prices and cost sharing in-network vs out-of-network. Health Affairs

• KFF Employer Health Benefits Survey 2024, PPO remains most common plan type. KFF Files

• KFF and Health System Tracker, No Surprises Act IDR outcomes through mid-2024. KFF+1

• AHCCCS (Arizona Medicaid), Single Case Agreement definition. AHCCCS

• MGMA Stat 2024, rising claim denials pressure. MGMA

• HHS OIG 2018, 75% of MA denials overturned on appeal. KFF 2025, <1% of denied marketplace claims appealed. Office of Inspector General+1

• CMS reviews and Commonwealth Fund summary, provider directory inaccuracies. CMS+1CCS