Chapter 1
The strategy call
Answer first
A growing psychiatry group was losing clinician time to intake calls, eligibility checks, portal messages, and scheduling. On the strategy call they asked how dedicated staffing actually works and whether outsourced staff could handle psychiatric terminology. We deploy dedicated virtual medical assistants who work only for this practice, 45 hours a week each, with a trained floater behind every seat.
Strategy call · transcriptanonymized
PR
Practice
Between intake calls, eligibility checks, and scheduling, my staff is underwater. I’m answering portal messages between sessions. That’s not why I went to medical school.
S
Staffingly
That’s the exact problem we solve. Any task you require, we deploy a dedicated person who’s only for your practice. We don’t rotate staff between multiple providers.
PR
Practice
How many people would we even need?
S
Staffingly
Most groups your size start with two or three. Each works 45 hours a week, which includes lunch breaks. One VA can easily handle 70, 80 encounters per day on the intake and phone side.
PR
Practice
Psychiatry has its own language though. Medications, diagnoses, the whole thing.
S
Staffingly
95% of our staff come with healthcare educational backgrounds. Many are PharmDs, we have medical doctors, we have licensed nurses on leadership. The medical terminology is no big deal because they have higher education.
PR
Practice
And if somebody doesn’t work out?
S
Staffingly
If you don’t like the staff member, unlimited replacements. It doesn’t usually happen that way, but if that’s a requirement, we handle it.
The call ended the way most of ours do: a summary of the meeting and the deck went out the same day, and the group agreed to a two-week 2-week free trial. What we found when we mapped their front office is Chapter 2.
Chapter 2
Research and findings
Answer first
Before anyone went live we mapped how work actually moved through the group’s front office. The finding was consistent: everything was interrupt-driven. Eligibility was checked at the window on the day of the visit, intake packets waited for a free moment that rarely came, and portal messages sat until after the last session. The fix was structural: three dedicated seats, one per queue, working ahead of the visit instead of behind it.
What the mapping showed. The group’s clinicians were full, which meant every administrative miss had a clinical cost. When eligibility was checked at the window, coverage surprises turned into awkward money conversations at the worst possible moment, and sometimes into visits that never got paid. When intake paperwork stalled, new patients who had finally worked up the courage to seek psychiatric care waited weeks for a first appointment that could have happened in days. When the phone rolled to voicemail during sessions, some of those patients did not call back. None of this was a people problem. The same front desk that was drowning was also excellent with the patients standing in front of it. It was a structure problem: one queue too many for the number of hands.
What we proposed. Three dedicated virtual medical assistants, each owning one queue. The first on patient intake and portal onboarding: chart creation, form bundles, demographics, insurance and card on file, follow up until every portal task is complete. The second on insurance eligibility verification: benefits, copay, and deductible confirmed and documented in the chart before the appointment, not at the window. The third on scheduling: booking, two-way reminders, and cancellation backfill inside the group’s own EHR. All three HIPAA trained, working under role-based access, with a BAA signed from day one and a trained floater behind each seat. This is psychiatry back-office outsourcing the way we run it everywhere: no new software, the practice keeps its own systems, and the work moves to people whose whole job is staying ahead of the visit.
The group’s leadership reviewed the plan in one sitting. The question that closed it was not about process. It was about pricing, and the answer was the same one we give everyone: $399 flat per week per dedicated specialist, no setup fees, no percentage of revenue.
Chapter 3
Training and onboarding
Answer first
Week one was setup: BAA signed, role-based access provisioned inside the group’s own EHR, the intake forms and eligibility workflow captured, and the three assistants trained to 80 to 90% ready before touching live work. A floater trained alongside each of them at no cost to the group.
Onboarding call · transcriptanonymized
S
Staffingly
First week is pretty much setup and our internal trainings to make sure they’re at least 80, 90% ready before they go live. Are we doing eligibility, are we doing prior auths, are we taking scheduling, are we talking to patients. We need to know exactly what we’re looking at.
PR
Practice
Patients kept hitting voicemail before. That’s my biggest worry.
S
Staffingly
No more voicemail. No more voicemails. Calls route to your dedicated person and they book straight into your system. It’s hands free. And we do a weekly 15-minute standup call just to make sure everything is going well.
What onboarding actually covered. The intake assistant learned the group’s new-patient packet form by form: which consents psychiatry requires, how the portal invitation flow works, and what a complete chart looks like before a first appointment. The eligibility assistant learned the payer mix, including the behavioral-health carve-outs where the mental-health benefit sits with a different administrator than the medical plan, exactly the wrinkle that had been producing surprises at the window. The scheduler learned the group’s booking rules, clinician by clinician, plus the reminder cadence and what qualifies as urgent versus routine on the phone triage side.
By the end of the week the group had something it had never had: every appointment on the next day’s schedule already verified, every new patient’s paperwork moving the day it arrived, and a phone that got answered while the clinicians were in session. The old between-sessions scramble was still available as a safety net. Nobody used it again.
Chapter 4
Going live: the pilot
Answer first
Week two the three assistants went live under the two-week 2-week free trial. Eligibility moved ahead of the visit, the intake backlog was worked oldest first, and the phones stopped rolling to voicemail during sessions.
- Day 1 liveEvery appointment on the next day’s schedule was verified before the office opened: benefits, copay, deductible, documented in the chart. The front desk started the day knowing, instead of finding out at the window.
- The intake queue turnsThe oldest new-patient packets were processed first. Patients who had been waiting on paperwork got portal access, forms, and a first appointment on the books.
- First standupThe 15-minute weekly call reviewed all three queues in one view: intake in motion, eligibility verified ahead, calls answered live. The practice manager saw the whole front office on one screen for the first time.
- Phones stay answeredWith a dedicated person on scheduling, sessions stopped being interrupted and callers stopped hitting voicemail. Reminders went out on cadence and no-show gaps started getting backfilled from the cancellation list.
- Decision pointDay 14, the go or no-go review. The group converted from pilot to the standard engagement and kept all three seats.
Nothing in the pilot was magic, and that is the point of these memoirs. It’s really the same process, just that you have dedicated staff taking care of it, starting it ahead of the visit, and never putting it down.
Chapter 5 · Current
Where it stands today
Answer first
The engagement runs today as a steady operation: three dedicated virtual medical assistants on intake, eligibility, and scheduling, a trained floater behind each seat, and a 15-minute standup each week. As the group adds clinicians, each new provider’s intake and scheduling folds into the same queues during onboarding.
The operating rhythm now. Eligibility is verified and documented in the chart before every appointment, so coverage conversations happen by phone in advance instead of at the window. New-patient intake moves the day it arrives: chart created, portal live, insurance and card on file, follow up until every task is complete. Scheduling runs with two-way reminders and cancellation backfill inside the group’s own EHR. When an assigned assistant is out, the floater steps in the same day. The weekly standup is the only recurring meeting the relationship needs.
What changed for the group. The clinicians got their between-session minutes back, and the front desk got to be present for the patient standing in front of it. Growth stopped being a staffing scramble: adding a clinician now means adding capacity to queues that already run, not hiring and training another front-desk unicorn. The engagement continues on the standard flat weekly fee, and this memoir grows with it: new entries are added as the work happens.
About this engagement
| Shelf | Memoir (delivered engagement) |
| Specialty | Psychiatry / telepsychiatry group |
| Services | Patient intake and portal onboarding, insurance eligibility verification, scheduling and reminders |
| Model | Three dedicated virtual medical assistants + trained floaters, $399 flat per week each |
| Compliance | BAA from day one, HIPAA-trained staff, SOC 2 Type 2, $5M E&O and cyber liability |
| Systems | The group’s own EHR and phone system, role-based access, nothing stored on Staffingly systems |
| Status | Active and growing. Entries added as the engagement continues. |
