Using Out of Network Benefits
Did you know that some insurance plans offer out-of-network reimbursement when you see a provider that is not in network with that plan? Plans with this option allow members more choice when selecting a provider in addition to the option of working with a certain specialist when there might not be one in your geographic area.
Many medical providers are either not included or opt out of working with certain insurance carriers – this is more common in fields like psychotherapy, psychiatry, chiropractic, and nutrition.
What types of plans cover out-of-network services?
The most common plan that reimburses for out-of-network services is a PPO (Preferred Provider Organization) insurance plan. HMO or EPO plans typically will only cover in-network services.
Can I get reimbursed if my therapist at Mindful Soul is out-of-network with my insurance carrier?
Sure! Our office will typically check on our end to see if you have out-of-network benefits as part of our intake process, however we always encourage prospective clients to be knowledgeable about your health plan. Knowing your options will surely factor into your decision to seek counseling here at our practice. We totally get it – therapy needs to be both a good fit AND sustainable! We find that many people are not properly informed on what their insurance company will reimburse. It is a pleasant surprise to learn that some insurance plans will reimburse you anywhere from 50-80% of the cost of your therapy sessions.
Ok, I do have out-of-network reimbursement as part of my plan. What do I do next?
The process to be reimbursed will vary by insurance carrier, so check with your plan by visiting the website or calling the member services number on the back of your card. It is usually as simple as logging in and submitting your paid invoice, otherwise known as a “Superbill.” In order for your insurance carrier to approve and reimburse you for your therapy, there are certain codes and details that must be outlined on the Superbill.
Superbill requests can be made by submitting the form below, which will alert the billing office of your superbill request. The form can be completed as often as you would like – some clients fill it out after each session, others do it monthly or less frequently. Once submitted, your request will be processed and a Superbill will be uploaded to the client portal in 72 hours.
If you have any questions or concerns regarding Superbills or other billing related issues, please email firstname.lastname@example.org.