Community Spotlight: Cassi Heuer, PMHNP of Elevate Wellness and Psychiatry

Cassi Heuer brought Spravato and TMS to a South Dakota town of 14,000. Here's what it took, and how she reclaimed 10 hours a week from paperwork.

In the middle of South Dakota, roughly 200 miles from the nearest major city, Cassi Heuer, PMHNP-BC, is building something her community didn't have when she was growing up: accessible, in-person psychiatric care.

Heuer is the founder of Elevate Wellness & Psychiatry, where she and her team provide medication management, Spravato® (esketamine), and TMS.

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"It is difficult to get psychiatric care here," Heuer says of her hometown of about 14,000. "It was very important for me to bring back care to my community that I didn't feel like was available or easily accessible when I was growing up."

She worked in private practice in one of South Dakota's larger cities, then at a community mental health center, before returning home to open Elevate, driven by a desire to offer interventional treatments her patients couldn't find close to home. Since partnering with Osmind, Elevate has grown its monthly appointment volume by more than 220% and reclaimed roughly 10 hours a week that used to disappear into billing and claims.

A practice built around insurance-based access

Unlike many interventional psychiatry practices that start cash-pay and add insurance later, Heuer built Elevate the other way around – out of necessity.

"We are in a smaller community, and cash-based practices are more unheard of in our area. Almost everybody uses health insurance, and so we had to have something that was robust in that sense – that could process lots of claims, help us with denials, rejections, all of that."

That meant billing, claims, and prior authorizations weren't back-office details. They decided whether patients could get care at all. And Heuer felt the tension acutely, because she was often treating patients for whom financial stress was itself a driver of their symptoms.

"A lot of people come in, the financial stress is a huge part of why their mental health isn't great. Seeing them and then having them walk out and saying, 'Oh, by the way, we need to collect your bill,' was very difficult for us. Having it all in one place – the claims, the organization, all outsourced – was so important."

What sealed her decision to go with Osmind

Heuer had already found plenty to like about Osmind before billing ever entered the conversation. But the arrival of comprehensive billing services turned her interest into a decision.

Since moving to Osmind 360, Elevate Psychiatry has saved an estimated two evenings per week on billing, claims processing, and prior authorizations, time that now goes straight back to patient care. For Heuer, that time is the whole point.

"There were so many things that we loved about Osmind. But when we found out they were getting the new billing integration and we could do that, that's what really hooked me. For ease of practice, that's one of the biggest things with burnout, I think: the documentation, all the different messaging, the prescription refills, the billing. It was very important to me to have a smooth-flowing system."

Since implementing Osmind 360, that's roughly two mornings a month back—time Heuer now spends with patients instead of on hold with a payer.

Growing a team without growing the learning curve

What started as Heuer working two to three days a week has become a multi-provider practice. Since transitioning to Osmind 360, Elevate Psychiatry's monthly appointment volume has grown by more than 220%

She brought on a medical assistant, then a second PRN provider, and once Elevate added a TMS machine, an office manager dedicated to prior authorizations, billing, and insurance. Onboarding that growing team, she says, was never the bottleneck.

"I always described it like Apple – everything is just very intuitive. You just click and can figure it out yourself. Things just make sense where they're at."

That ease mattered most for her second provider, who came from a corrections facility with no electronic prescribing or portal messaging at all.

"For her, it was incredible to transition to this newer EHR – she just caught on. I don't even know if we really did much training."

A team, not a ticket system

Heuer has now worked with Osmind across several platform upgrades and recently moved from Osmind One (software only) to Osmind 360 (all-in-one platform and billing solution).

For Heuer, what's carried through both platform transitions isn't just the software. It's the relationship.

"I think it's just the trust, knowing that you have a team that's actually going to get back to you. We know everybody by name. Nothing's ever going to go perfectly with billing, especially with health insurance. Having that team that you know is going to help you figure it out has been invaluable to us."

That trust extends to the Psychiatry Collective community as well, which Heuer says has shaped how she thinks about running Elevate.

"Even the little things you don't get elsewhere have given me a lot of ideas — seeing what other practices are doing and thinking, 'we need to shift there too.'”

Advice for clinicians ready to start or grow their practice

The biggest thing Heuer wants other clinicians to know is about mindset going in.

"You really have to have the passion for mental health, because our burnout rate is so high. I don't have many days where I work eight to five – and I think that's just part of being a business owner."

That reality is part of why she built Elevate on a platform that could absorb administrative work wherever possible, so the hours she has go toward patients.

"Expect things, especially at the startup, to take more time. Meet with a financial advisor, meet with an attorney, have everything documented. It costs more money upfront – but really take those steps to make sure you have a good plan before you transition."

Local referral relationships matter just as much. "Connecting with local therapists is really important, too."

Growing a practice in an underserved market takes a team, a plan, and infrastructure that keeps pace with both. For Heuer, Osmind is part of all three.

Psychiatric care shouldn't stop at the city limits. See how Osmind's billing team clears the path through denials and prior auths so your hours go to patients, not paperwork. Book a walkthrough.