Building Trust In Mental Healthcare
January 10, 2023
By Leila Ghaznavi
This interview has been edited for length and clarity.
One of the inaugural recipients of the Nirvana Gives program, Sonya Veytsman is a licensed clinical therapist and graduate of Fordham and Columbia who specializes in anxiety and relationships. Motivated by her personal experiences growing up supporting family members who were grappling with chronic physical and mental health issues, Ms. Veytsman is dedicated to supporting those in need. I had the pleasure of speaking with Ms. Veytsman about her experiences with the Nirvana Gives program and the timely impact it had on her clients, her practice, and mental healthcare as a whole.
How did you find Nirvana?
I was on forums for therapists searching for billing solutions for out of network clients and I saw Nirvana’s name come up repeatedly. As a therapist, you can hire a biller but they charge you about 8% of your total earnings. I was just starting my practice and needed to minimize my overhead so the biller model wasn’t a fit for me. Talking with other therapists, I learned that Nirvana charges a flat monthly fee, which made it very affordable for me. So, I reached out and did a consult with Akshay Venkitasubramanian, the Chief Executive Officer for Nirvana, about my practice and decided to give it a try.
How did the Nirvana Gives program affect your therapy practice?
I learned about the program in Nirvana’s monthly newsletter and instantly decided to apply. As with most providers, I have clients who are out of network, struggling financially, and can't afford my fee. I listed just a few of my clients in my application and was fortunate enough to be chosen. The award came at the perfect time because I had a client that really needed it and was on the verge of stopping therapy because she couldn't afford it any longer. The client was dealing with a chronic illness and had to quit her job as a result. She felt like everything was weighing her down and nothing was going in her favor. Every place that she was trying to break through, she met some sort of opposition - everything was a battle. I didn't want therapy to be a burden as well. The Nirvana Gives program was a blessing. I was able to tell her that because of Nirvana Gives, her sessions were completely paid for temporarily. The Nirvana Gives program really supported her during that difficult time and we’re both very grateful. It's a wonderful thing that Nirvana is doing to give back to the community.
Given your range of experience with the service, how would you describe Nirvana?
For therapists, out of network reimbursement is super complicated. We usually leave it up to the client to submit their therapy Superbills to their mental health insurance providers on their own, but I think you lose a lot of potential clients that way. Clients are overwhelmed by the Superbill submission process. They often don't know how insurance works so you end up losing potential clients whom you could be helping-- who could afford services with the proper resources.
Nirvana helps provide those resources! For example, the insurance calculator on the website. If the clients’ insurance information isn't on the Out-of-Network Reimbursement Calculator, you can reach out to firstname.lastname@example.org and they can provide an estimate of the cost. This information allows you, the therapist, to be ethical and transparent early on. You can provide your clients an estimate of what they can expect to pay and explain that they pay an upfront cost, but Nirvana will submit the claims to their insurance on their behalf and a few weeks later they'll be reimbursed. I think clients really appreciate that clarity. They aren’t overwhelmed by the insurance process and they can easily evaluate if therapy’s something they can afford. If there are any issues with the final cost, you can have an open dialogue to make sure that the cost of care works financially for all parties. That level of clarity can determine if a client opts to proceed with therapy or if they walk away.
What Nirvana tool helps you the most?
The Out-of-Network Reimbursement Calculator. It’s amazing. Insurance companies are notoriously opaque. I almost wonder if it’s on purpose, that they make it complicated and difficult to deter providers and to keep people from using their benefits. When I used to call these insurance companies on my own, at the end of the day I still didn’t know what the benefits were and how to translate that for my clients. But on the Nirvana website, there is a calculator that aggregates all the client’s mental health insurance information and then through the algorithm Nirvana can provide a quick and clear cost estimate: this is your deductible, your deductible will be met X number of sessions, and the reimbursement is approximately Y. I haven't seen anything like it anywhere else.
The only other option is hiring a personal expert on billing, and even then, they don't have the data right. They just have their personal experience which is incomplete and ends up costing you a lot more (that 8% of your total income I mentioned before).
How do you think Nirvana is impacting mental health care and insurance?
I think Nirvana is helping revolutionize mental health care, particularly in a positive way, because it's using technology to improve access to health care and unlock Out-of-Network reimbursement for therapy in a way that ultimately saves time and money.
By supporting providers and making their lives easier (including donating mental health for those in need), Nirvana helps clinicians provide services to a wider range of people. Nirvana has helped me figure out how to support my clients without also overloading myself. I can't always give away services for free and there's a balance to be struck between supporting my clients and supporting myself – Nirvana has helped me to find that balance. Nirvana is transforming mental health and the access that people have to care, and that's wonderful.