Out of Network Therapist | Superbills and Health Insurance

In our therapy practice we often get phone calls where the immediate question is, "Do you take my health insurance"? If we say no, most people assume that they can't meet with us. The reality is many health insurance plans offer "out of network" benefits, which means that you can get reimbursement for meeting with an out of network provider. This video will help you know how to find your out of network benefits, and also navigate the process of using your health insurance to cover some of the costs of meeting with an "out of network" therapist.
The first step is to decide if you WANT to use your health insurance. Most people do, but some don't want their mental health diagnosis to become part of their permanent health record.
Most people are ok with their mental health diagnosis becoming part of their record, and so the next step is to contact your insurance company and find out the exact rate they will reimburse you for meeting with an out of network therapist. Each plan is different. Some have excellent out of network benefits, some don't have any.
Questions to ask your health insurance company about your out-of-network benefits
(1) What is my out-of-network coverage for outpatient mental health visits?
(2) Is there a deductible that needs to be met prior to services? How much of my deductible has been met this year?
(3) Is there a limit on the number of sessions my plan will cover per year?
If Yes, How many?
(4) Do I need a referral from an in-network provider or a primary care physician to see someone out-of-network?
(5) How do I submit claims for out-of-network reimbursement?
(6) Are virtual outpatient mental health visits (or teletherapy) covered by my plan?
(7) Is there anything else I need to know about utilizing my out of network benefits (limitations, rules, or other "small print" things to know).
Nate Page, PhD, LP, CGP
northfielddynamictherapy.com
grouptherapycentral.com

[@tanheide6]

This was super helpful!! Thank you so much for making this video! Everything makes so much more sense now!

[@CranialCrownProsthetics]

Hi ! I need help filling out the Superbill. I was looking for the template you use.