How Grow Therapy Turned Insurance Friction into a Conversion and Retention Advantage

About Grow

Grow Therapy’s mission is to make high-quality mental health care accessible and affordable for everyone, and insurance coverage is central to that. Yet finding in-network care and getting transparent cost information remain real challenges. In 2021, patients went out of network about 3.5 times more often for behavioral health visits than for medical visits (RTI International, 2024). Grow aims to close that gap so that anyone who needs therapy can find the right provider, use their insurance, and know upfront what it will cost.

Challenge: Cost transparency was a growing challenge as Grow expanded its network to higher complexity payors.

Grow’s booking experience is built to be easy, intuitive, and instant. Patients filter by state and therapist type, find an in-network therapist, get a cost estimate, and book. When Grow’s network was limited to large national payors, calculating accurate cost estimates up front through their own internal logic was feasible. As Grow continued to expand to new, higher complexity networks and benefit structures continued to change, however, it needed a new approach to providing accurate estimates.

“Cost estimates are a moving target. As soon as you get them right, benefit structures change. At Grow we have a high bar for accuracy. If we don’t have confidence the estimate is right, we don’t show it. As a result, as we continued to expand to new complex spaces, fewer users got cost transparency up front. At this point, continuing to rely solely on home grown investment no longer seemed like the right approach considering the many strategic priorities we were focused on at the time. After extensive research, Nirvana stood out as just the partner we needed to collaborate on a sustainable long-term solution.” Steph Bartley, Lead Product Manager, Grow Therapy

Grow’s hypothesis was that partnering with a reliable vendor fully focused on the complexity of this space, with the resources to work on the problem full-time, would strengthen their own product. The ultimate goal was to give every user a real-time, accurate cost estimate, no matter how complex the payor, which would in turn drive conversion and retention and build trust with clients.

Why building fully in-house became unsustainable

A patient’s cost for a single visit sits inside the payor’s eligibility response (an EDI 271), a document built to describe an entire benefit plan rather than one appointment. A single response can contain hundreds of valid data points: in-network and out-of-network, individual and family, plan-year totals and remaining balances, repeated across every covered service type. Isolating the one figure that applies to a therapy session takes logic tailored to each payor and plan design, and that logic has to be maintained as benefits change year over year. That was manageable across a smaller network; across hundreds of payors, it became a full-time discipline. As a result, Grow decided to bolster the fidelity of their home grown product through an integrated approach with Nirvana.

Solution: Instant, accurate cost estimates at booking

Grow looked outward and evaluated eligibility vendors on two measures: coverage (did the check return a result at all?) and accuracy (was the result right?), and Nirvana ranked first in Grow’s evaluation of 8 vendors. Grow started with a pilot, and the partnership grew from there. Today, Nirvana is a core part of Grow’s benefits platform.

Transparency Grow can see

Nirvana maintains a performance and accuracy dashboard in OneVerify (Nirvana’s customer-facing platform for eligibility reporting) that gives Grow real-time visibility into coverage and accuracy of the results they produce.

“The accuracy and coverage dashboard has been great for us. It gives us a look behind the scenes we didn’t have before - surfacing things like what share of clients meet their deductible each year or hit their out-of-pocket max. Having that kind of visibility has built a lot of trust.” Ben Schuster, Product Manager, Grow Therapy

Results: Higher conversion and retention where patients see a cost estimate

Grow tracks three things: how many patients see an estimate, how many book appointments, and how many stay. The first compares before and after launch. The other two compare patients who saw an estimate with patients who didn’t. Implementing Nirvana has had a significant positive impact on all three. 

1. More patients saw what they’d owe. The share of patients shown a cost estimate rose 35 percentage points, from before launch to today.
2. More patients booked. Year to date in 2026, patients who saw an estimate booked at higher rates than those who didn’t:

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3. More patients stayed. To understand retention of customers who were shown cost-share information, Grow looked at two groups. Those that were shown deductible cost information at time of first booking and then those who were not shown information at time of booking. Among patients who were shown accurate deductible information, a point where high upfront costs often cause drop-off:‍

• +3.5pp more reached five appointments than those who were not shown cost share information‍
• +4.6pp more reached five appointments among patients who had already completed two appointments.

“Every one of those extra conversions is a person who got into therapy without digging for an insurance card or putting off booking for another day. It’s part of what makes this work feel meaningful.” Mike Danello,  Engineering Manager, Grow Therapy

What’s next

Grow and Nirvana share the mission of ensuring patients have access to clear and transparent pricing prior to receiving care. Grow and Nirvana plan to keep widening estimate coverage and accuracy and extend into revenue cycle management. Specifically, they’ll use rejection and denial flags in eligibility checks to catch problems at intake, before a claim is ever submitted.

“Our goal is to remove as much insurance-related friction as we can, for as many clients as possible.” Ben Schuster,  Product Manager, Grow Therapy