Spotlight on Silver Linings Mental Health

Q&A with Owner/Founder Samantha Silverman

Samantha Silverman is the passionate owner of Silver Linings Mental Health, a virtual counseling practice serving clients across Colorado with accessible and affordable mental health services. Our interview is below:

Find & follow Silver Linings Mental Health: Website  |  Instagram  |  Facebook

Q: Thanks for sharing your story with us! Please introduce us to your work and your business.

A: I am the proud owner of Silver Linings Mental Health. Our focus is on delivering virtual mental health services to residents throughout Colorado. We accept a variety of major insurances, including Medicare and Medicaid, ensuring accessibility and affordability for counseling services across all age groups in the state.

Silver Linings originated as a solo endeavor in 2017, and it has flourished into a team of 17 therapists. Additionally, we are excited to welcome a Nurse Practitioner to our team in March 2024. My personal connection to mental health, fueled by my experience surviving the 9/11 terrorist attacks at the World Trade Center in New York City, has greatly influenced not only my professional journey but also my lifestyle choices and the growth of the business.

Q: What preventive mental health strategies would you recommend that state lawmakers focus on to reduce the long-term societal and economic impacts of mental health issues?

A: State legislators can play a crucial role in mitigating obstacles to mental health by offering additional support to behavioral health clinicians in navigating complex health insurance systems.

The challenges related to managing insurance matters are universal within Colorado-based counseling practices, with such issues standing as the primary hindrance to delivering mental health care. We are fortunate to have a grass-roots advocacy group named COMBINE that actively engages with lawmakers, politicians, and news reporters, and regularly communicates through email threads with its members in order to strategize, clarify new developments, and identify obstacles practitioners are facing.

The realm of health insurance is a convoluted and heavily regulated landscape. Mental health care providers often face obstacles such as denied payments for claims, rigorous audits, low reimbursement rates, clawbacks or recoupment demands, and unexplained claim denials. These constraints have led practice owners and providers to opt out of accepting health insurance, favoring private pay practices. Unfortunately, this shift can be detrimental to clients who may already be paying high monthly premiums for care.

The intricate work involved in insurance billing is often hidden from clients, who may not be aware that issues related to insurance, billing, and follow-up comprise a significant portion of the administrative workload. Striking a balance between running a successful health practice and appeasing health insurance companies proves to be a considerable challenge.

Q: In your opinion, how could our state government better support crisis intervention and ongoing support for individuals with severe mental health issues?

A: Enhancing mental health and crisis intervention support from our state government can be achieved by expanding the role of Ombudsman or hiring additional Provider Relations experts to facilitate communication between mental health practices and insurance companies.

A recent article highlights the diminishing support for both group practice owners and Coloradans seeking mental health. While large insurance companies often assign "Provider Relations" roles to coordinate care with mental health practice owners, these roles frequently encounter challenges such as overwhelm, burnout, high turnover rates, delayed, or even no, responses. There is a pressing need for independent mental health advocates who are compensated fairly and can operate separately from the influence of insurance companies.

Q: What have been some of the most significant challenges and rewards of running a mental health practice?

A: One of the most significant challenges and rewards in managing a mental health practice revolves around the acceptance of insurances. I find immense satisfaction in meeting our clients' mental health needs and ensuring they can utilize their insurance benefits for counseling.

The joy of saying, "Yes, we do accept insurance!" when a client contacts our intake line is truly indescribable, especially considering that we are often not their initial point of contact. The audible exhale from clients upon learning that we accept Medicaid and Medicare adds to the rewarding experience. Our status as a private company, with minimal internal bureaucracy, allows us to seamlessly handle new client intakes.

Navigating Colorado Medicaid, however, poses its own set of challenges due to the lack of parity between the Regional Accountability Entities (RAEs) for claim reimbursement. Colorado Medicaid consists of 7 distinct RAEs, and providers must undergo separate credentialing with each RAE. These RAEs are verified through the HCPF (Colorado Department of Health Care Policy and Financing) portal. Each RAE operates as an independent entity with its own set of rules and regulations, determining reimbursement rates for their specific region. Dealing with denied or rejected claims entails reaching out to the individual RAE, a process that can be both frustrating and time-consuming, particularly as behavioral health clinics often face difficulties in receiving reimbursement for their services.

Q: What are your future goals for Silver Linings Counseling, and how do you plan to continue evolving the services offered to meet the needs of your clients?

A: We have recently introduced the Silver Linings Institute, which is accessible here. The primary objective of the Silver Linings Institute is to offer psychoeducation on fostering resilience after experiencing trauma.

In my role as a therapist, I've observed many clients identifying strongly as victims of their traumatic experiences. Embracing a victim’s mindset not only impedes personal growth but also obstructs future self-actualization. It is crucial for me to destigmatize this perspective and provide psychoeducation on Post Traumatic Growth, a positive outcome that arises from the process of healing after trauma.

I believe that anyone can undergo growth and healing from their trauma, given the right motivation and openness to change. Following the terrorist attacks, I grappled with insomnia, depression, anxiety, chronic ear disease, and cholesteatoma (a rare upper respiratory tract disease resulting from the implosion during the 9/11 events and inhaling harmful contaminants at ground zero).

Instead of succumbing to further despair, I viewed my experience as an opportunity for personal transformation. I transitioned from a career as a Wall Street associate to becoming a Clinical Social Worker, returned to my family, and rebuilt my life from the ground up.

Dealing with survivor's guilt and PTSD, I recognized life's fragility and took charge of my own. Leveraging my strengths and addressing my weaknesses, I implemented positive lifestyle changes, including daily physical activity, outlets for creativity, and strengthened connections with loved ones.

Empowering my clients to take control of their lives has become my passion. The Silver Linings Institute will soon offer a self-paced course on cultivating resilience after trauma, providing Continuing Education Credits for therapists. This course will be accessible on our website, and I aim to have my team deliver it to external organizations, fostering widespread education on seeking resilience after trauma.