Abundant Practice Podcast – Episode #743

Private Pay OOO, feat. Sanjana Sathya

Date: March 25, 2026
Host: Allison Puryear
Guest: Sanjana Sathya, Thrisr (Thrizer)

Episode Overview

In this episode, host Allison Puryear dives into the evolving landscape of private pay therapy practices, focusing specifically on “out of network” (OON) benefits. Joined by Sanjana Sathya—co-founder of Thrizer, a payment and OON claim platform—they discuss why therapists are increasingly moving away from insurance panels, how clients can leverage OON benefits, and actionable strategies to make private pay practices more accessible and sustainable. The episode is rich with practical advice for both therapists and clients considering or utilizing out-of-network benefits.

Key Discussion Points & Insights

1. Sanjana’s Personal Connection to OON Benefits

[03:47]

• Personal Journey: Sanjana shares her background as a therapy client and her professional trajectory in healthcare, including pharmaceutical consulting and primary care management.
• Her personal struggles with navigating super bills as a client led to her involvement with Thrizer—and eventually marrying the company’s founder, Ronak.
  • Quote:
    “Mental health has been such a personal passion of mine... to bring my healthcare background, but specifically my mental health passion together [at Thrizer], is just kind of a dream come true.” (Sanjana Sathya, 05:55)
• Sanjana also reveals her recent ADHD diagnosis, emphasizing how mental health continues to influence her life on multiple levels.

2. Understanding Super Bills and OON Benefits

[07:56]

• Therapist and Client Perspectives:
  • Many clients (and therapists) misunderstand super bills; they often don’t realize they can get reimbursed by insurance even when seeing an out-of-network provider.
    • Quote:
      “I never tied [a super bill] with out of network benefits... are you saying I can get reimbursement from my insurance plan even if my therapist doesn’t accept insurance? That’s literally what Thrizer does.” (Sanjana, 08:20)
  • Allison admits she’s been bad at submitting her own super bills as a client, losing out on significant potential reimbursements.
  • Most therapists hand the super bill to clients, while only a few manage OON reimbursements themselves.

3. Shifts in the Private Practice Therapy Landscape

[10:32]

• Market Changes:
  • Allison notes the past year has been transformational: private pay practices are now somewhat easier to run than insurance-based ones, due to more discerning clients and greater demand for specialized care.
    • Quote:
      “The private pay therapists who are speaking really well to that one problem are staying full and getting full in a way that seems harder for people who are taking any insurance.” (Allison, 12:05)
• Impact of Big Therapy Tech:
  • There’s greater market saturation from therapy apps and platforms, changing how clients choose providers.
• COVID’s Influence:
  • Increased demand for therapy with no corresponding increase in in-network provider supply, pushing more clients to private pay therapists.
    • Quote:
      “The demand for therapy went up, but then the supply of in network therapists did not go up. And the reason... is because historically, right, insurance companies don’t take care of mental health practitioners.” (Sanjana, 12:25)
• This shift presents an opportunity for private pay therapists to niche down and use tools like OON benefits to make therapy accessible.

4. How Thrizer Streamlines OON Benefits for Therapists & Clients

[16:13]

• Traditional OON Process:
  • Clients first pay the full session fee, then manually submit a super bill via email, fax, or insurance portals (which are often confusing and rarely used).
  • Lack of submission transparency—claims feel like they’re “sent into an abyss,” and clients may front large amounts with long waits for reimbursement (e.g., paying $800/month before receiving anything).
• Thrizer’s Solution:
  • Integrated Payment + Claim Submission:
    • Therapists use Thrizer as their payment processor. Every payment automatically triggers a claim to insurance—no more manual super bills.
      • Quote:
        “An out of network claim is automatically submitted... every time you charge a client... no more back and forth on super bills.” (Sanjana, 16:47)
  • Transparency:
    • Clients and therapists can track claim status at any point and get support from Thrizer to check on insurance progress.
  • Thrizer Pay:
    • Once a client meets their deductible, they pay only their "copay" or coinsurance up front (sometimes as little as a quarter of the session fee). Thrizer covers the balance to the therapist, then collects from insurance directly.
    • Risk Absorption:
      • If a claim is denied despite estimates, Thrizer absorbs the loss for those sessions (up to the first denial), never retroactively billing therapist or client.
      • Quote:
        “We actually absorb the difference for that session... We won’t go back to the client or the clinician and back-charge them.” (Sanjana, 23:06)
  • Free OON Calculator Widget:
    • Thrizer offers a free out-of-network benefits calculator for therapists’ websites, so clients can instantly check if they qualify and estimate reduced fees.
      • Quote:
        “Just having an out of network benefits calculator on your website... is step one.” (Sanjana, 21:44)
  • Cost Structure:
    • For therapists: only a 3% card transaction fee, no other clinician fees.
    • For clients: 5% fee applies only once deductible is met and discount kicks in.

5. Why OON Benefits Empower Therapists and Clients

[22:10]

• For Clients:
  • Makes high-quality, specialized therapy more accessible and affordable, even when therapists are private pay only.
  • Reduces administrative burden and uncertainty about insurance reimbursement.
• For Therapists:
  • Ensures consistent payment of full session fees, without the risk of insurance nonpayment.
  • Frees up time and energy to focus on clinical work and building a niche practice.
    • Quote:
      “It takes a lot of the frustration and risk out of it for... the therapist.” (Allison, 22:19)
• Differentiation Opportunity:
  • Private pay therapists who leverage OON benefits and clarify their niche can thrive even amid industry-wide changes.
    • Quote:
      “If you step out of that competition... and you’re speaking to that one ideal client, it helps people who can and will afford you make it this easy choice to choose you.” (Allison, 15:49)

Notable Quotes & Moments

• “Mental health has been such a personal passion of mine... to bring my healthcare background, but specifically my mental health passion together... is just kind of a dream come true.”
  — Sanjana Sathya, 05:55

• “I never tied [a super bill] with out of network benefits... That connection wasn’t made. It was just like, hey, here’s an invoice.”
  — Sanjana, 08:13

• “The private pay therapists who are speaking really well to that one problem are staying full and getting full...”
  — Allison, 12:05

• “The demand for therapy went up, but then the supply of in network therapists did not go up.”
  — Sanjana, 12:25

• “An out of network claim is automatically submitted to insurance every time you charge a client. So there’s no more back and forth on super bills.”
  — Sanjana, 16:47

• “We actually absorb the difference for that session... We won’t go back to the client or the clinician and back-charge them.”
  — Sanjana, 23:06

• “It takes a lot of the frustration and risk out of it for... the therapist.”
  — Allison, 22:19

Timestamps for Key Segments

• Sanjana’s Journey & Thrizer Origin Story: 03:47 – 07:18
• Explaining Super Bills & OON Benefits: 07:56 – 09:41
• Market Trends & The Shift Toward Private Pay: 10:32 – 15:08
• How Thrizer Works (Detailed Walkthrough): 16:13 – 22:10
• Risk Absorption & Claim Denials Explained: 22:18 – 24:26
• Getting Started with Thrizer & Free Tools: 24:31 – 25:27

Resources & Next Steps

• Thrizer Website: thrizer.com
• Free OON Calculator Widget: Available on Thrizer’s website; can be embedded on any therapist’s site regardless of whether they use other Thrizer services.
• Special Offer: Free trial with waived card fees for the first $2,500 in charges (link in show notes).
• Allison’s Abundance Party & Private Practice Resources: abundancepracticebuilding.com/party

Conclusion

This episode demystifies out-of-network benefits for therapists and clients alike, offering actionable strategies to leverage these benefits for a more sustainable, profitable, and accessible private practice. Sanjana’s expertise and lived experience shine through, making the case for therapist empowerment and client-centric innovation in the changing therapy landscape.