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Continuing care after a client's benefit ends

  • Updated

After a client uses all their benefit-covered sessions, they can continue care through insurance or self-pay. As the client approaches their last few covered sessions, they are prompted through email and on their Tava Health account homepage to ensure coverage is up to date for future sessions. Providers can also track benefit usage directly on the client profile.

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Tava Health will always display all available coverage options to the client for every session, and clients can choose to adjust their coverage anytime before a session begins.

How to transition care after benefits end

  • Review the client’s current coverage method and remaining benefit sessions.
  • Confirm whether the client has added their insurance or self-pay method.
  • Discuss continuity of care with the client as clinically appropriate.
  • Continue using the same Tava Health client record and scheduling workflow, noting that any previous session duration requirements no longer apply.

Client coverage options to continue care

During the last benefit session, be sure to discuss the client’s next steps and provide referrals if needed. This helps ensure continuity of care and a smooth transition. Options include: 

  • Client can use a credit card, HSA card, or FSA card to pay for sessions out of pocket.
  • Client can use insurance if you are in-network, or insurance with another in-network provider.
  • Client can contact their benefit sponsor for additional authorized sessions.
  • Wait until their sponsored sessions reset at the start of their next coverage period.
  • End therapy if treatment goals have been met.

Does the referral type change?

No. If the client is a Tava Referral, the client remains a Tava Referral after the benefit ends. Moving from sponsored coverage to insurance or self-pay does not convert the client to a self-referral. Similarly, if the client is a self-referral that was using a benefit to cover their sessions, they remain a provider-generated referral after all benefit sessions have been used.

Learn more about client referral types and rate buckets here.

What happens to the provider rate?

Tava Referrals who continue after sponsored sessions are still paid under the Tava Referral rate structure. Custom cash rates and sliding-scale discounts do not apply to Tava Referral clients.

If the benefit sessions had duration restrictions, these no longer apply once the coverage method has changed. This means providers may choose to hold sessions of 53 minutes or longer, and will be paid according to the provider’s 53+ minute Tava Referral or Self-Referral rates.