Pitfalls of Working for Tech Companies as a Therapist
I often see posts from fellow therapists along the lines of, “I need to earn some extra income. Anyone have experience with [insert random telehealth tech company]?”
Every time I see these questions, I cringe a little—not because I don’t understand, but because I absolutely do. I’ve been there myself, especially after having a child and trying to figure out how to make full-time work fit into my life post-maternity leave. It’s tough feeling stuck in a low-paying job, brainstorming ways to pay the bills and keep your family afloat.
And that’s exactly where these tech companies swoop in. They know we’re looking for options, and they capitalize on our need for flexibility and extra income, all while paying therapists as little as possible to maximize profits for their investors.
So, let’s talk about why therapists are drawn to these platforms, why I don’t recommend working for them, and what you might consider instead.
The Three Main Types of Tech Therapy Platforms
1. The “Chathelp” Platforms:
These companies market themselves to clients as affordable services with 24/7 access to a therapist. They have huge marketing budgets and often use celebrities, YouTubers, and podcasters to promote their services. They don’t usually bill insurance but offer monthly subscription packages with a set number of sessions or text exchanges. [Spoiler alert, the subscription packages aren’t that affordable!] Despite high fees for clients, therapists typically get paid very little—often around $30 per 45 minute session. On the therapist side, they promise flexible scheduling and unlimited referrals, and they onboard quickly. Most hire therapists as 1099 contractors.
2. EAP and Virtual Doctor Companies:
These platforms contract with employers to provide Employee Assistance Program (EAP) services and on-demand telehealth. They promise therapists flexibility and relief from administrative tasks. Pay is usually a bit better—often $50-100 for a 45-minute session. They also tend to hire as 1099 contractors, though occasionally you’ll find a W2 position.
3. The “Billing” Platforms:
These companies claim to make it easier for clients to find therapists who accept their insurance, advertising low out-of-pocket costs. For therapists, they promise to handle all the insurance headaches—billing, verification, even audit protection. Some charge monthly fees, some per referral, and some are “free.” They’re often marketed as a way to “grow your own practice,” and usually pay the highest per session of the three.
Why are therapists drawn to these platforms?
After my son was born—and again during the pandemic—I needed more flexibility and better pay. At the time, I was making about $22 an hour (based on a 40 hr work week). When I started searching, the “Chathelp” and “VirtualDr” companies seemed promising so I joined a few. My thoughts here come from both personal experience and what I’ve heard from other therapists. I believe there are a few reasons, some are based on fact/reality but others hype and distorted marketing.
Quick Onboarding = Quick Money
It’s tempting to go for a platform that promises fast onboarding and immediate referrals, especially when private practice setup feels daunting. But quick onboarding doesn’t always mean quick clients. Some of the platforms required quite a bit of training for how to use the platform and submit documentation. On one of the platforms, I had months of open availability and barely received any referrals.
Numerous Referrals
Big-budget platforms such as the “Chathelp” category, do tend to have lots of clients, but they also tend to pay the least. The VirtualDr, EAP and Billing platforms promise referrals but often deliver very few. Another downside: high client turnover. Many platforms encourage clients to “shop around,” which means you’re constantly starting over and rarely get closure in the therapeutic process.
Flexible Scheduling
This is one genuine perk– but it’s not exclusive to working with these companies, you would also have a flexible schedule with solo private practice. Most platforms let you set your schedule and choose your client load—unless you’re a W2 employee, in which case there may be more structured requirements.
No Administrative Burden
It’s true—these platforms handle calendars, paperwork, and the telehealth tech, making it easy to just log in and see clients. Some are user-friendly, others… not so much.
But remember, as a 1099 contractor, you’re still a business owner. You’ll need to track your income and expenses for taxes. If you don’t have enough withheld from your W2 job, you could face penalties for underpaying estimated taxes. It’s important to stay on top of your finances even if “you’re only doing side work” for one of these platforms..
(Keep a look out for an upcoming blog about tracking expenses.)
Billing support
Billing platforms promise to handle everything: verification, claims, audit/clawback protection, even payment guarantees if insurance doesn't pay. Some therapists have had smooth experiences, but others report serious issues—like verification of benefit errors that result in clients being undercharged for months and then suddenly charged with no notice when the error is corrected. Customer support can be hit or miss, and promises of audit protection or no clawbacks sometimes change with updated terms and conditions.
Why I Don’t Recommend Working for These Companies
My 2 cents…
Here’s the reality: These platforms are for-profit companies, focused on their bottom line and their investors. As therapists, we’re already dealing with insurance companies—adding another middleman often just doubles the disadvantage. While the platforms offer some perks, they come at a big cost to both therapists and clients.
On the client side, there are concerns about data privacy and misleading marketing. The FTC has fined some of these companies for selling user data. There’s a class action lawsuit currently ongoing against another one for collecting and sharing user data. Their marketing toward clients is often misleading. Promises of 24/7 access are misleading—clients can message anytime, but therapists aren’t responding around the clock (nor should they!). Claims of “affordable” insurance-based therapy are often just smoke and mirrors—the copay or deductible is what it is, no matter where you go.
But let’s focus on why I don’t recommend therapists work for these platforms:
You’re Building Their Business, Not Yours
The time and energy you spend onboarding and providing great care helps grow their platform, not your own practice. Clients refer friends to the company, not to you. Long-term, you’re investing in their business stability, not yours.
You Lose Control
When you work for a platform, they can change the terms, reimbursement rates, fees, record-keeping requirements, and even data privacy policies whenever they want. You have far less say than you would in your own practice. What might have started out as a referral stream dries up, or suddenly costs you. If you decide to move away from the platform, you have to start all over with credentialing and practice systems if you relied on using the platform’s.
Private Practice Can Be Streamlined
With a good EHR and some solid systems, private practice isn’t as daunting as it seems. Scheduling, intake paperwork, billing, appointment reminders, secure messaging, insurance billing, bookkeeping—it can all be streamlined and automated. Yes, setup can take some time, but once it’s done, it’s smooth sailing and you’re in control.
The Money Matters
If I’m going to offer therapy for $30 an hour, I’d rather give that rate to someone uninsured or underinsured than to a corporation that pays therapists peanuts, sells user data, and exists to profit shareholders. I do panel with a few major insurance companies– their rates are sustainable for where I live, and I believe in helping people use the benefits they pay for. Rates vary by location, but for context: Heard (an accounting service for therapists) found the average insurance reimbursement rate in the US for 2025 was $111, and in NC it was $145. Using an easy number, if I get $110 for a 55 minute session- 90837, that equals $2 a minute. Compare that to $30 for a 45 minute session- 90834- on a “Chathelp” platform– just $0.66 a minute. Don’t forget that most of the Chathelp, EAP and VirtualDr platforms cap the sessions at 45 minutes or a 90834 CPT code, so you can’t earn more by extending the session. That’s less than a third of what I could be earning on my own.
Marketing—It’s Worth It
Yes, you’ll need to do some marketing in private practice, but it pays off long-term. When clients recommend you, they’re building your business—not just sending people to a faceless platform. Even if you never go full-time, you’re investing in yourself.
You Can Choose Your Ideal Clients
Running your own practice lets you focus on the issues and populations you’re best equipped to help. On big platforms, you get whatever comes your way, whether it’s a good fit or not. If you decline or refer out, it may impact the platform’s algorithm and decrease the amount of future referrals you receive.
In Summary:
Tech platforms can seem like a quick fix, but they often come with hidden costs for therapists and clients. If you’re considering your next step, I encourage you to invest in yourself, build your own practice, and create the flexibility and income you deserve—on your own terms.
If you’re interested in learning more about running your own private practice, contact me to schedule a coaching call. We will go over the questions and concerns that you have and I will offer you personalized tips and my 2 cents.
I’ll be doing a series soon about the costs of opening a private practice, with options for those looking for side income as well as full-time work. Keep an eye out for this post!