What Will My Clients Pay? A Guide to Cost & Insurance on Tava
One of the most common questions providers ask is what to tell clients about the cost of care. When a client adds their insurance to Tava, we provide an estimate of what they will likely owe for each therapy session so they have a clearer picture of cost before getting started.
| Important: This estimate is not a bill or a guarantee of the client’s final responsibility. The actual amount a client owes is determined by their insurance company after the claim is processed. In most cases, the estimate is close to the final amount, and Tava aims to make it as accurate as possible. |
How Insurance Billing Works at Tava
When a client joins Tava using insurance, here's what happens:
- The client enters their insurance information during intake.
- Tava verifies their benefits directly with their insurance company — including their deductible status, copay or coinsurance, and remaining out-of-pocket maximum.
- Tava determines the contracted rate between the insurer and your practice.
- The client's cost is calculated based on their plan structure:
- If they've met their out-of-pocket maximum: They owe $0.
- If their plan has a copay: They pay a flat fee per session (e.g., $30).
- If their plan has a deductible and coinsurance: They pay the full contracted rate until their deductible is met, then their coinsurance percentage (e.g., 20%) after that.
- Clients are not charged until after a session is completed and the claim is processed.
Note: Tava bills at a standard rate required by insurance (e.g., $341), but your client's cost is based on their plan's allowed amount (e.g., $131) — not the billed amount. In some cases, if a client's deductible hasn't been met and your cash-pay rate is lower than their plan's allowed amount, they may pay less by using self-pay. It's worth being transparent about this, and encouraging them to check with their insurance.
Why the final cost may differ from the estimate
Estimates are based on the best information available at the time they are generated, but a few things can affect the final amount.
Timing of other claims: An estimate reflects benefits at a specific point in time. If the client has other medical claims processed after the estimate is created but before the therapy claim is billed, their deductible or out-of-pocket balance may change.
Mid-year plan changes: If the client changes insurance plans, their benefits may change as well. The estimate may not reflect that new plan until benefits are re-verified.
Claim processing rules: In some cases, the insurance company may process the claim differently than what was reported during the benefits check.
Coordination of benefits: If the client has more than one insurance plan, the way those plans coordinate payment can affect the final amount owed.
If a client wants a specific estimate before signing up, direct them to:
- The member services number on the back of their insurance card
- Their insurance company's online member portal
If a Client's Insurance Isn't Accepted at Tava
Option 1: Use Flexible Billing.
You can add a client to Tava without requiring insurance or a credit card upfront. Add them as either a Full Access or a Limited Access client, then toggle off coverage and fee enforcement in their Client Preferences. This lets you schedule them immediately and sort out billing details later — or bill them outside of Tava entirely.
How to Add Clients Without Requiring a Credit Card →
Option 2: Verify insurance first, then switch to Full Access.
Add the client as Limited Access to check their insurance network status and estimated costs in Tava, without notifying the client or prompting them to complete intake. Once you've confirmed their coverage looks good, convert them to Full Access to invite them to the platform.
How to Convert a Client's Access Type →
Common client questions and how to answer them
"Will I be charged before my first session?" No. Clients are not billed until after a session is completed and the claims have been processed by insurance.
"Why might insurance cost more than paying cash?" If a client's deductible hasn't been met, their cost is based on the plan's allowed amount — which can sometimes be higher than a provider's direct cash-pay rate. It's worth checking both options together.
"How do I know what my copay or deductible is?" The easiest way is to call the member services number on the back of their insurance card or check their insurer's online member portal.
"Could my actual charge be different from the estimate?" Yes, in some cases. Estimates are based on benefits at a specific moment. If other medical claims are processed between your estimate and your session being billed, or if your insurer applies different rules when processing the claim, the final amount may differ slightly.