From the Green Velvet Couch | A Conversation with Sonda Kunzi
Behind every great behavioral health practice is an army of people most patients never meet. They are the ones who make sure a suicide loss survivor can keep her therapy sessions, that an intensive outpatient program gets reimbursed correctly, and that a clinician’s note actually tells the story of the care they provided. Sonda Kunzi is one of those people, and she is remarkably good at behavioral health billing.
On her podcast, From the Green Velvet Couch, Shelly sat down with Sonda, the CEO of Coding Advantage and a longtime partner to Shelly’s own behavioral health company. With more than 30 years of healthcare experience and a long list of national certifications in coding, billing, auditing, and compliance, Sonda has built her career around advocating for providers and patients alike. What made this conversation special was how clearly that advocacy came through, not as policy language, but as heart.
Here are the moments worth holding onto.
The Question She Asks Before Any Other
When Sonda starts working with a new behavioral health client, her opening question is different from the one she asks other medical specialties. She does not begin with paperwork or pricing. She asks about the mission.
Physicians treating hypertension, she explained, have a relatively simple mission. Get the patient stable. Adjust the medication. Move forward. Behavioral health organizations operate on a different plane. They are helping people find housing, complete disability paperwork, rebuild their ability to work, and navigate the full complexity of a human life. Their mission usually reaches far beyond symptom relief, and Sonda needs to understand that mission before she can match the care to a billable service code.
That orientation changes everything about how she approaches her work. She is not just a biller. She is a translator between the world of clinical care and the world of regulatory language, and she takes that role seriously.
When Coverage Stops Before Healing Does
One of the most powerful parts of the conversation came when Shelly and Sonda talked about what happens when a patient’s insurance coverage ends before their recovery does. Behavioral health care often involves levels of treatment most medical specialties never touch, like intensive outpatient programs and partial hospitalization, which require a specific number of treatment hours each week.
Imagine a patient finally beginning to function again. They can shower. They can parent. They can hold a job. Hope has returned for the first time in a long while. Then the insurance company sends a letter saying their coverage will not continue. For someone whose life may literally be at stake, that moment becomes another layer of trauma stacked on top of everything else.
This is the territory Sonda fights in daily. She advocates for patients she will never meet, and her work is one of the reasons many people get to keep the care that is saving their lives. Shelly’s own experience leading a behavioral health group has made her deeply aware of how much clinical outcomes depend on the people working behind the scenes. This kind of systemic advocacy work is one of the reasons her wellness consulting services for healthcare organizations take a whole-system view rather than focusing only on clinical staff.
The Clinician’s Note That Almost Got It Right
Sonda shared a frustration that any therapist will recognize. She will sit down with a clinician whose note is missing a critical element, and when she asks about it, the clinician immediately launches into the full backstory of the patient. Every detail is there. Every therapeutic intervention is clear. Every reason for the level of care is obvious.
None of it is written in the note.
Clinicians get so immersed in the intimate work of helping a person heal that the documentation step can slip past them. Sonda’s job is to gently bring those missing pieces back into the record so the care gets reimbursed and the provider stays protected. She does it without judgment, because she understands how much clinicians are carrying.
The two of them laughed about how documentation is never a one-and-done lesson. It has to be reinforced constantly, not because clinicians are careless, but because the work itself is so demanding that the administrative layer can quietly disappear.
Staying Inspired in a Heavily Regulated World
Shelly asked Sonda how she stays inspired in an industry where regulations constantly change and where a single misinterpretation can unravel months of work. Sonda’s answer was refreshingly honest. She is not always inspired. Sometimes she reads a regulation and wants to throw her laptop out the window.
What keeps her going is the way she frames the work when she is training teams. Rather than reciting compliance rules like a checklist, she tries to show providers how the regulations can actually protect them when the documentation is written correctly. She refuses to teach from a PowerPoint of rule numbers, because she knows nobody remembers them and nobody stays inspired by them. The human story has to come first.
This approach mirrors the way Shelly works with her own clients. Compliance, wellness, and leadership all thrive when the rules serve the mission rather than replace it. It is the same principle behind her executive advising work with founders and healthcare leaders.
Building a Healthy Remote Team
Sonda’s company is fully remote, and her team handles something that can feel very transactional. Coding and billing do not carry the same emotional reward as direct patient care, which makes it easy for morale to slip if a leader is not paying attention.
She and her team have built a culture around flexibility and outcomes. Need to leave to pick up your child? Fine. Need to take your kid to the doctor and make up the hours later in the evening? Fine. They do not count keystrokes. They count results. If the client’s work is getting done well, then the team is getting it right. That is the measurement that matters.
Sonda also talked about the importance of reminding her team that they are supporting organizations doing life-changing work. Without the billing infrastructure, those organizations cannot keep their doors open. She wants her team to feel the weight of that mission, even when they are looking at spreadsheets and claim denials.
The Mental Game of Obstacle Racing
Ask Sonda how she unplugs and you will get an unexpected answer. She runs Spartan races, the kind of obstacle course events where participants crawl through mud, climb walls, and carry heavy objects across long distances.
She described these races as roughly 90 percent mental and 10 percent physical. Every few miles, the course hands you a new obstacle and forces you to strategize in real time. While she is on the course, she never once thinks about work. It is one of the only times in her week when her mind fully lets go.
Shelly shared her own version of this kind of reset. Her outlet is horses, and she recently brought home a mini horse named Snickers. The psychology of working with animals gives her the same kind of mental break, even though she is still engaging her clinical mind in a different way. Both women agreed that these kinds of practices are not optional. Without them, leaders simply cannot sustain the care they are trying to give to everyone else.
This kind of intentional recovery is central to Shelly’s performance mentoring work with executives, entrepreneurs, and high performers, where sustainability is the real marker of success.
Women in Business, Imposter Syndrome, and the Tribe That Helps
The conversation closed with an honest exchange about being a woman in a historically male-dominated industry. Sonda has been building her business for more than a decade, and she has watched the healthcare consulting world slowly diversify. She acknowledged that women tend to absorb client stress differently, sometimes losing sleep over things their male counterparts seem able to set down more easily.
Shelly added her own observation about the double standard women often face when building a business. There can be more scrutiny, more pressure to prove how you got where you are, and more skepticism to push through before the work itself is even evaluated.
Both women also spoke about imposter syndrome. Even after years of success, the feeling of “should I really be in this room?” still shows up from time to time. The answer, almost always, is yes. Sonda pointed out that having a strong community of female business owners to talk to makes a real difference. There is strength in the tribe, and she is unapologetic about leaning into it.
Healthy leaders know they cannot do this work alone. That truth, more than any regulation or coding rule, may be the most important lesson of the whole conversation.
🎧 Join the Conversation
If this post sparked something in you, the full episode is waiting with even more warmth and thoughtful insight.
✨ Listen to the full conversation on the From the Green Velvet Couch podcast. Visit the Podcast page to discover more episodes focused on resilience, leadership wellbeing, and holistic wellness.
Let this be your invitation to slow down, breathe deeply, and step into a well-grounded life full of growth and intention.
