We operate under a strict Zero-Export Protocol. We never download, export, cache, or locally store patient medical records on our hardware. All work takes place 100% inside your existing US-hosted EHR portal (SimplePractice, TherapyNotes, or Jane App).

During onboarding, you provision our user credentials under the restricted "Scheduler" or "Practice Manager - Billing" role with the "Clinician" role permanently toggled OFF. This programmatically blocks our team from ever viewing or opening your private psychotherapy progress notes. We sign a standard federal HIPAA Business Associate Agreement (BAA) on Day 1 legally accepting civil liability for data safeguards under 45 CFR Parts 160 and 164.

No. We engineered our infrastructure specifically to prevent that. Our operators connect to your EHR exclusively through dedicated US-based static VPN tunnels matching your specific practice state jurisdiction (e.g., Maryland IP for a 301 area code).

To SimplePractice, TherapyNotes, or Availity, every remote session appears as a standard local domestic administrative touchpoint, completely eliminating automated foreign IP geoblocks, MFA lockouts, or fraud flags.

This is our most critical safety boundary. Our operators are non-clinical administrative specialists: we never conduct clinical assessments, discuss diagnoses, or provide therapy advice.

Any incoming inquiry, SMS, or portal message expressing acute distress or safety sentinel keywords (such as hopeless, hurt myself, end it, suicide, pills, crisis) immediately bypasses standard queues. Within 5 minutes, our team executes the Emergency Escalation Protocol: we dispatch an urgent SMS alert formatted as "URGENT SAFETY FLAG: Patient [Name] sent high-stress message in portal. Please review immediately" directly to your emergency cell phone, while sending standardized 988 Suicide & Crisis Lifeline information to the client.

You never have to change your advertised practice phone number. We utilize encrypted OpenPhone VoIP endpoints with a dedicated local US area code.

You simply activate Conditional Call Forwarding (CCF) on your carrier line (*71 on Verizon, *21* on AT&T, **21* on T-Mobile). When you are in-session or busy, unanswered calls automatically route to our trained desk after 3 rings during business hours. We act as your seamless, invisible front desk.

Prospective therapy clients seeking care typically contact 2 to 3 providers on Psychology Today simultaneously. Over 80% of bookings go to the first provider who responds with warmth and logistical clarity.

When solo therapists wait until the evening to return voicemails, that client has often already booked with a competing group practice. In our live pilots, our average response latency is 14 minutes, producing a 75% booking conversion rate (compared to the solo industry average of 40%).

When a client submits a late cancellation notice, our team intervenes within 30 minutes. We scan your active EHR waitlist for clients who requested that specific time of day or format (telehealth vs in-person), and dispatch immediate SMS outreach to offer the vacant slot.

This automated backfill loop recovers approximately 50% of empty hours that would otherwise be permanently lost, protecting your $150–$200 billable hour.

Several commercial payers enforce daily session duration caps and reject 53+ minute individual therapy sessions (CPT 90837). When our weekly Availity audit flags a rejection, we rebuild the claim to CPT 90834 (45-minute individual psychotherapy), recalculate the allowed fee schedule, verify diagnosis pointer consistency, and resubmit within 48 hours to prevent frozen cash flow.

Telehealth billing rules vary widely between commercial payers and Medicare/Medicaid. We systematically audit your claim batches to ensure Modifier 95 (Synchronous Telemedicine Service) or Modifier GT is attached alongside the correct Place of Service code: POS 02 (Telehealth Provided Other than in Patient's Home) or POS 10 (Telehealth Provided in Patient's Home).

Before Session 1 takes place, we log into clearinghouse portals (Availity) or place direct calls to commercial payers (BCBS, Optum/UHC, Aetna, Cigna) using authorized caller consent. We verify:

• Whether outpatient psychotherapy (CPT 90837/90834) is an active covered benefit.
• Exact patient copay or coinsurance liability.
• Individual annual deductible and how much has been satisfied year-to-date.
• Whether prior authorization (PA) or referral is mandatory.

Our retainer is calibrated to session-equivalency math. At a standard $160 out-of-pocket rate, our Practice Care retainer ($799/mo) equals the value of just 5.0 billable clinical sessions.

When our 2-hour response SLA converts just 2 prospective inquiries who would have otherwise called another clinic (generating ~6 recurring sessions in Month 1), and our 30-minute recovery backfills 2 late cancellations (~2 sessions), we safeguard 8 billable sessions ($1,280 gross). After deducting our fee, your practice retains +$481 in net surplus cash in Month 1—paying for itself entirely while liberating 45+ hours of administrative time.

Paying Nivilia is as straightforward as paying a domestic US SaaS vendor. Payments are made via standard domestic US ACH bank transfer to our dedicated virtual US bank account provided via flat-fee B2B payment rails (Skydo/Xflow).

To fully satisfy your CPA and IRS compliance, we supply a pre-completed IRS Form W-8BEN-E during onboarding. As an active foreign entity performing services 100% remotely outside the US with zero permanent US establishment, Article 7 (Business Profits) of the US-India Double Taxation Avoidance Agreement (DTAA) legally exempts your practice from 30% US backup withholding and waives any Form 1099 reporting requirements.

Onboarding requires exactly 15 minutes on a brief video walkthrough or screenshare. You never have to spend hours writing training manuals or recording Loom videos.

We step into your practice already fluent in mental health workflows, CPT coding, and EHR mechanics. We simply collect your practice fee schedule, cancellation policy, and restricted EHR invite link, and deploy our pre-tested workflows immediately on Day 1.