Navigating mental health coverage doesn't have to feel like wandering in the dark.

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How Therapists Are Using The Nirvana Calculator

What is the Out-of-Network Reimbursement Calculator? 

Nirvana’s Out of Network Reimbursement Calculator provides an instant breakdown of your clients’ mental health benefits from the comfort of their preferred device. Say goodbye to portal logins and phone calls and hello to transparent insurance information! 

The calculator breaks down your client’s insurance information in a few ways. We’ll let them know:

  • If they have an active insurance plan
  • If that insurance plan covers out-of-network mental and behavioral health services
  • How much their deductible and out-of-pocket maximum is
  • Approximately how many sessions it will take to reach their deductible and out-of-pocket maximums
  • An tailored estimate of how much they’ll receive in insurance reimbursement for each therapy session

You can customize the calculator to only show your practice or therapists, and you can embed it as a widget in your website (optional). For only $10-$20 per month*, you and your clients have access to unlimited mental health benefit checks for over 700 insurers nationwide.

Try it out for yourself below!

*The Calculator is $10/month for one therapist, and $20/month flat fee for 2-40 therapists. There is no contract period and no cancellation notice required.

Who can use the Calculator?

The Calculator was designed to be a client-facing tool but clients are not the only ones who benefit from using it! Therapy practices of all sizes and tenure use our Calculator to make insurance more transparent. 

Newly licensed therapists often use our Calculator to attract new clients and build their caseload. The Calculator is great for solo practitioners because it was designed to be self-servicing for clients. Clients figure out their own benefits and reimbursement and you won’t need to hire an assistant or admin to help with insurance questions. 

Larger therapy group practices often have their admins and office managers use the Calculator to cut down on phone calls with insurance. Practices with multiple locations can also use our Display Name feature to write in the locations a therapist works at, or even set specific rates per location. For example:

Why should I use the Calculator?

Insurance is hard. At its worst, insurance can even be a barrier to a client receiving the care they need. Many clients have never dealt with out-of-network insurance before, or may have had a negative experience dealing with out-of-network coverage after a hospital stay or urgent care visit.  

With large healthcare companies like Alma, Headspace, and Teladoc making insurance verification an instant, easy, and even a mandatory part of the intake process, clients may even expect insurance to be verified for them. 

Therapists often tell Nirvana that prospective clients stop responding to emails after insurance enters the conversation. Recently, a therapist shared that one client admitted to having never checked their insurance benefits after over a year of sessions!

Luckily, the Calculator is simple. Listed below are some ways therapists get the most out of their Calculator.

Attract new clients

Trying to grow your practice? Don’t lose clients at the “do you accept insurance” part of the conversation. Therapists often use our Calculator to attract new clients and build their caseload, all while making the insurance and payment aspects of therapy easy and transparent.

Give your practice a competitive edge

There are intelligent and experienced therapists all over the country, and teletherapy has taken proximity out of the equation for clients in many cases. Providing a convenient and low-effort way to verify your clients’ insurance benefits may be the thing that sets you apart from another practice or therapist! The Calculator is an easy and cost-effective way to show clients that you are sensitive to the frustrations of insurance, without taking on the burden of mental health benefit checks yourself.

Increase your fees

After years in your field, you feel it’s time to raise your rates. Adding the Calculator to your website or sending it to clients in conjunction with your new rate announcement can soften the blow of this news because the client knows they will still get reimbursed for their sessions.

Regain your time

If your practice helps clients understand their insurance benefits manually, you may find yourself spending 40+ minutes on each client’s eligibility check and need a login for 5-6 different insurer portals. After filling in all the necessary fields, Nirvana’s Calculator can complete a mental health benefit check in 30 seconds or less for over 700 insurers nationwide!

Transition from in-network to private pay

If you’ve decided to terminate your insurance contracts and remove yourself from an insurance panel, your clients are bound to have questions. The good news is that if a client has a PPO plan, they will likely have out-of-network coverage for therapy! You can use the Calculator to show clients that while they probably won’t be paying the same copay, they can still use their insurance to cover therapy sessions.

Set sliding scale rates

If your client’s insurance covers out-of-network therapy they may be able to get back up to 60-100% of what they pay you. Alternatively, a client with no out-of-network coverage, may be a good candidate for a sliding scale fee. Either way you will be empowered to make a more informed decision about your fees.

How Does a Client Use the Calculator?

To use the Calculator, clients will need to provide only 5 pieces of information:

  1. Their name
  2. Their date of birth
  3. The name of their therapist (existing or potential)
  4. The name of their health insurance company
  5. Their insurance member ID number

Once they’ve typed in this information, the Calculator will provide results in 30 seconds or less. Results will vary depending on the client’s insurance plan, the therapist’s location, and the therapist’s session rate, and the session type selected. 

A client with out-of-network mental health benefits will see a results page like this:

Here is what it looks like on a mobile device:

From there, Nirvana begins breaking down the client’s benefits into clear phases, while highlighting key pieces of information like their total and remaining deductible and how many sessions they’ll need to submit a superbill or a claim for before they can get reimbursed by their insurance company.

Phase 1:

The client has not spent enough on out-of-network healthcare this year to reach their deductible. The client is not eligible for insurance reimbursement for therapy yet.

Phase 2:

The client has spent enough on out-of-network healthcare this year to meet or exceed their deductible.

Phase 3:

The client has spent enough on out-of-network healthcare this year to meet or exceed their out-of-pocket maximum (this is the point at which a health insurer is responsible for covering 100% of the allowable amount for therapy). The client may be eligible for even more reimbursement for therapy!

How do I set up my Calculator?

From the checkout page, add your Primary Practice Email Address. Then, type the therapist name or NPI, set the session rate, and session type. Click +Add another therapist to add each therapist in your practice. Enter your payment information on the next page and you will receive an email with your Calculator link and HTML code for embedding, within one minute.

Adding the Calculator to Your Website

Embedding Your Calculator

Once you have your embeddable HTML code, you can add the tool to your website as a widget. If you have a staff web designer or developer, you can ask them to embed this as an iframe. If you make website updates yourself, don’t worry! Embedding an iframe is easy with popular website builders. Here are some how-to guides for embedding iframes:

Calculator Location

We’ve found that Calculators get the most usage when they are located in easy-to-see places on landing pages related to payment, fees, investment, or insurance. If you don’t have a page like this on your website, consider adding one!

Other practices choose to dedicate a whole webpage to their Calculator, with titles like “Check Your Insurance Coverage,” “Insurance Checker,” or even “Out-of-Network Insurance Calculator.” Some practices will add it to their FAQ page, but be careful with this method as it can cause the Calculator to be missed or overlooked. 

Wherever you decide to place your Calculator, make sure it’s at the top of the page. If a client has to scroll down to the bottom of the page to find the calculator, they might miss it altogether.

Calculator Size

The OON calculator’s default sizing is 1250 px height and 1000 px width, but you are welcome to change the sizing to your preference and website’s style. If you want the calculator to be the main focus of the page, try making it a little bigger! 

The Calculator is optimized for mobile screens so it automatically adjusts when using it on a phone or tablet. We always recommend reviewing the mobile version of your website to see how it looks.

Calculator Web Copy

We recommend including a short blurb about the purpose of the OON Calculator on your site so clients know why it’s there. Feel free to use our standard copy below, or come up with your own!

"While we are not in-network with any insurance providers, we understand that our clients may still wish to use their out-of-network benefits for reimbursement. Many clients have out-of-network benefits, but may not understand how to use them.

We’ve partnered with Nirvana Health, a company that advocates on behalf of therapy seekers, to provide transparency into your out-of-network benefits so that you have greater insight into what reimbursement is possible with your plan."

To sum it all up, Nirvana’s Out-of-Network Reimbursement Calculator has many benefits and there are many ways to use it. It improves the client intake process, makes your practice more competitive, and helps make mental health care more accessible. Remember - the faster a client knows their costs, the more likely they are to set up care.

For more information, check out our Insurance Verification page, email us at help@meetnirvana.com or schedule a 1:1 call with our Onboarding Team.