As behavioral health practices continue to grow, expand across states, and navigate hybrid care models, many leaders face the same challenge: How do you scale without overwhelming staff or losing patients to operational friction?
This is the story of how one California- and Texas-based outpatient psychiatry group used Valant’s behavioral health EHR and carefully designed workflows to support multi-state growth, streamline communication, and make an overnight pivot to virtual care, all while keeping the patient experience stable and supportive.
Background
Amy Carabay is the Vice President of Clinical Operations in the behavioral health division of Central Coast Behavioral Health, Inc. a rapidly growing behavioral health division of a practice in California.
Today, the mental health division:
- Operates multiple locations in California and Texas
- Supports 16 providers in California and 3 in Texas, with more planned
- Offers outpatient psychiatric services, medication management, and a Spravato program
- Delivers care in a hybrid model: 80% virtual, 20% in-office
Throughout this growth, Valant has remained the behavioral health EHR supporting their clinical and operational workflows.
The COVID Turning Point: A Shift to Virtual Care in “A Day and a Half”
When COVID hit, the entire clinical model had to transform instantly.
“We had to go from…seeing patients in office to seeing patients virtually in a matter of a day and a half,” Amy said.
For a practice managing complex psychiatric medication workflows and high patient volumes, this could have easily derailed operations. Instead, they used Valant as the foundation to rebuild telehealth workflows, manage documentation, and maintain continuity.
Even during the most chaotic behind-the-scenes moments, patients continued receiving care without feeling the disruption. That stability became a core point of pride for the team.
Solving Communication Bottlenecks With Dedicated MA Roles
As growth accelerated, one of the biggest pain points was patient communication. With rising volumes, patients were calling various lines, reaching random staff members, and often bypassing the phone tree entirely to “press 0” for a live person.
To streamline this, the practice created a new medical assistant role dedicated to administrative support. Each MA supports 2–3 providers, managing:
- Medication refills
- Specialty letters
- Disability paperwork
- Side effects or clinical questions
- Message triage between patient and provider
This model ensures every patient has one consistent point of contact, which dramatically improves clarity, trust, and the overall patient experience.
“It’s something so simple, but…it made a huge difference…because they’re talking to their one person,” Amy said.
The practice now employs 6–7 MAs to match its provider growth.
Expanding Operational Capacity With a 24/7 Offshore Team
Local hiring was a challenge — “they might look good on paper, but sometimes it just doesn’t work out” — especially as the practice expanded into new states.
To remain responsive, they built a dedicated offshore operations team trained entirely on Valant.
This team:
- Handles billing
- Manages new patient intake
- Supports a 24/7 phone line
- Monitors Valant updates and maintenance notifications
Because they work exclusively within the MSO ecosystem, they function as an extension of the internal staff rather than an outsourced third party.
This structure allowed the practice to grow without overwhelming its U.S.-based team without sacrificing responsiveness to patients.
Reducing Friction Without Losing Patients
To keep people from abandoning care, they took a two-path approach:
- Use Valant’s tools where they work best: They leverage prospective patient management to collect demographic and pre-visit information before converting someone to a full patient record.
- Create a backup intake flow when tech becomes a barrier: They use a separate system to gather basic demographics and a consent form. The provider completes intake during the first appointment instead of requiring everything upfront.
This lets them meet patients where they are — especially those who are stressed, not tech-savvy, or overwhelmed by long digital forms.
“They’re coming to us to…minimize their stress and we’re stressing them out with the intake process…We’ve been really trying to hone in on what it’s going to take to make this more seamless,” Amy said.
This approach “just ensures that that patient’s gonna keep that appointment” and reduces the cognitive and technical load on individuals seeking mental health care.
What Other Practices Can Learn from This Team’s Approach
This practice’s journey offers practical, actionable lessons for behavioral health leaders facing similar challenges.
- Put a behavioral health EHR at the center of your operations: A specialized system like Valant can sustain growth across providers, locations, and complex psychiatry workflows without forcing clinical workarounds.
- Build roles around communication, not just tasks: Assigning one MA per 2–3 providers created continuity and deeper rapport. Patients feel cared for, not shuffled around.
- Consider a hybrid staffing model: A trained 24/7 offshore team allowed the practice to scale without burning out internal staff or compromising timely intake, billing, and scheduling.
- Treat intake as a clinical experience: A long or clunky intake can cause patients to abandon care. Reducing friction—through MYIO customization, prospective patient tools, or a streamlined alternative—can increase kept appointments and reduce stress.
- Shield patients from internal chaos: Whether it’s rapid telehealth adoption or back-end workflow changes, the patient should feel steady. This practice succeeded because even during major transitions, patients experienced uninterrupted, supportive care.
“Being able to find the right tools and know how to utilize them better, to help patients and be more efficient with our work… that’s the key,” Amy said.
