How Rivia Mind Verifies Patient Eligibility in Under 3 Seconds with Nirvana
Published:
April 3, 2025
Published:
April 3, 2025
Rivia Mind is a hybrid mental health practice offering psychiatric and psychotherapy treatment across five states. With a holistic therapy approach and focus on broad access and high-quality care, Rivia Mind is already setting a new standard for clinical excellence.
With shifting patient eligibility and increasingly complex insurance plans, traditional manual benefit checks are often unsustainable, diverting time from care and calling for additional dedicated staff.
This scenario is common, even for innovative practices like Rivia Mind. As their patient headcount skyrocketed in 2024, Tiffany Fagan, Patient Operations, recognized that Rivia Mind's manual eligibility verification process needed to evolve to support their growth.
Confirming patient benefits required that staff navigate through individual payer portals and dial multiple call centers. "Some payers put us on hold for nearly two hours and limited us to verifying three patients at a time," says Tiffany.
Things grew more complicated if their patient intake data didn't precisely align with payer records. According to a recent review, 18% of patients provide incorrect information at intake — an issue Tiffany experienced firsthand. "If we discovered any intake data discrepancies — such as the use of a preferred name or an outdated address — we were back to square one," Tiffany explains.
Last year, when Tiffany was assessing the plan to manage annual benefit renewals in early 2025, she knew that manual processes would limit Rivia Mind's capacity to verify benefits. This workload would undoubtedly increase the risk of unexpected out-of-pocket patient expenses and coverage lapses.
Tiffany knew there was a better way — and she was committed to simplifying verification before benefits reset in 2025. With this goal in mind, she started looking for a solution that would:
Several solutions promised to fulfill her team's needs — but below the surface, most relied on the same manual processes that slowed down Rivia's verification process in the first place. As year-end approached, the urgency to find an effective solution intensified.
That's when Tiffany discovered Nirvana.
"You need significant manpower to verify new patients and check the coverage of every existing patient at the beginning of the year to make sure they're still eligible. We tried some solutions, but none offered the powerful AI capabilities, accuracy, and speed that Nirvana did."
With Nirvana, Tiffany turned Rivia Mind's verification process into a simple, lightning-fast workflow that generates accurate benefit data — regardless of limited intake information.
At the center of this transformation is OneVerify, Nirvana's AI-powered eligibility management platform. Instead of navigating multiple payer portals and call centers, Tiffany simply uploads CSV files containing relevant patient demographics that require verification. She can then access coverage and cost details within a single, easy-to-use dashboard. With this feature, her team efficiently checks benefits for hundreds of weekly visitors and verifies Rivia Mind's entire patient panel following the annual benefits reset at the start of the new year.
On the back end, Nirvana's machine learning models interpret plan details from hundreds of payers, while in-house expert billers continuously verify its data against new insurance schemes and policies. This ensures Tiffany's team has access to the most up-to-date information, eliminating the need for them to spend time manually reviewing payer policies and chasing down insurance details.
Once verification is complete, Nirvana's Coverage API seamlessly channels all relevant insurance information back into OneVerify. The platform presents this data in a standardized format, regardless of payer-specific variations and complexities. This comprehensive analysis, along with proactive identification of patients at risk of denial, enables Tiffany and her team to prevent claim rejections before they occur. Rather than treating patients whose coverage has lapsed, she proactively emails patients with next steps to ensure they are verified prior to their appointment. By streamlining this process, Rivia Mind's staff is freed from endless follow-ups to track down intake information, ensuring all appointments are verified and billable.
"We use Nirvana for bulk eligibility checks and verifying insurance for individuals just coming into the practice. At the beginning of the year, we verified all active patients with future appointments in just 30 days. It was a real game-changer."
In less than three months with Nirvana, Rivia Mind streamlined their entire benefit verification process — from intake to continuous care. Tiffany and her team now spend their time supporting Rivia Mind’s patients and continued growth.
Here's what Rivia Mind has achieved with Nirvana so far:
Looking ahead, Tiffany plans to use OneVerify to verify eligibility for two specific groups — those whose benefits reset around June and students whose coverage refreshes with the academic calendar. Nirvana helps Rivia Mind to pursue its mission of enabling greater access to high-quality, accessible mental health therapy and affordable care.
"I love that Nirvana has a really good product that leverages innovative AI technology — but I also love working with their team. They're genuinely happy to help us with anything, and they're very responsive. I'm excited for what they have in store for the future."
Navigating healthcare coverage and costs doesn't have to feel like wandering in the dark.
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