So-called insurance ‘clawbacks’ are driving Georgia mental health therapists into private practice

Georgia Public Broadcasting by Ellen Eldridge, March 4, 2025.

Many therapists want to be accessible to clients with insurance, but doing so is risky when billing errors and complex coding rules lead insurance companies to “claw back” previously paid reimbursements.

Tracy Hooper is one of a dwindling number of licensed professional counselors (LPCs) in Georgia who still takes insurance, even when it costs her business more to do so. Everyone else in her practice, located about 40 miles north of Atlanta in Holly Springs, has clients who pay out of pocket for mental health care services.

The insurance company Hooper has been working with for many years blindsided her by demanding reimbursement for what amounted to six months’ worth of sessions with a client — a year later — over a billing issue.

“They realized that they paid out of the wrong plan — which I have no way of knowing which one is primary,” she said. “And then they came back for all of the money.”

This clawing back of payment is devastating to business owners like Hooper.

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