Out of Network Support

What is a superbill?

A superbill is a detailed receipt that gives your insurance company the information it may need if you would like to ask for reimbursement for services you have already paid for.

Unlike a standard receipt, a superbill includes additional information your insurance company may require, such as the dates of your sessions, provider information, and diagnosis and procedure codes.

I cannot guarantee that your insurance company will reimburse you. Every insurance plan is different, and reimbursement depends on your specific out-of-network benefits.

How Does It Work?

1. You pay for your sessions at the time of service.

2. I provide a superbill through the client portal upon request. It will include the information your insurance company may need to process your claim.

3. You submit the superbill to your insurance company.

4. Your insurance company reviews the claim. If your plan includes out-of-network benefits and the services are eligible, your insurance company may reimburse you directly according to the terms of your plan.

Questions to Ask Your Insurance Company

Before submitting a superbill, it may be helpful to understand what your insurance plan covers for out-of-network mental health services.

You can call the number on the back of your insurance card and ask about the following:

Out-of-Network Coverage

• Do I have out-of-network benefits for outpatient mental health counseling?
  If so, are these services (universal billing code provided) covered?
  90791 — Initial session
  90837 — Follow-up session
  90847 — Family or relationship counseling

• What percentage of the session fee is reimbursed?

• Does my plan cover services that use Z codes, including relationship or family counseling? (If applicable.)

Deductible

• What is my out-of-network deductible?

• How much of my deductible have I met so far this year?

Session Limits & Requirements

• Is there a limit to the number of sessions covered each year?

• Do I need pre-authorization for out-of-network counseling?

• Is a referral from my primary care provider required?

Superbill Submission

• How do I submit a superbill?
  For example, can I submit it through an online portal, by mail, or by fax?

• Is there a deadline for submitting a superbill?

• How long does it typically take to process a claim?

A Few Things to Know

A few things are worth keeping in mind when using out-of-network benefits:

• Reimbursement varies. The amount your insurance company reimburses depends on your specific plan and benefits.

• A superbill does not guarantee reimbursement. Your insurance company determines whether a service is eligible and how much, if anything, it will reimburse.

• Payment is due at the time of service. You are responsible for the full session fee regardless of whether your insurance company reimburses you.