Why we choose to be Out of Network
Out of Network Providers & Superbills
We choose to work out of network with insurance companies. Choosing to be an out-of-network provider allows us more flexibility in how we provide treatment. It also allows us to set our own rates. Insurance companies always reimburse therapists lower than their rate, regardless of the expertise, or experience of the therapist.
Choosing to be out-of-network allows us flexibility in how we document treatment and therapy. If we were providing services in-network, insurance will only pay for diagnosis codes that they deem appropriate for treatment. What that means is that if you do not have a diagnosable mental health disorder, your insurance likely will not provide coverage for our services.
We believe that counseling is beneficial for many in achieving the life they want to live. It can help resolve conflict in families and relationships; allow you to develop confidence to achieve your goals; and provide an overall sense of well-being and self-acceptance. While insurance companies may not be willing to pay for those benefits, we believe they are well worth the cost for improved mental and physical well-being.
What's a Superbill -
A superbill is a one-page document that we create after your session. It will include the date and time of the session, the cost that you paid, and a diagnosis. This can be submitted to your insurance company potential reimbursement to you. The insurance company's decision to reimburse is based on their out of network rates. Each plan is different. It will also take into account whether you have met your deductible. Most are willing to pay 50% -80% of their out-of-network rate. (That means if they pay out-of-network counseling a lower fee than ours, they will reimburse you based on that fee).
We are not contracted with insurance companies and are unable to verify for you if they will reimburse for services. Most do, however, you can call your insurance company and ask about out-of-network benefits for counseling.
How does this all work -
When you attend sessions with us, we expect payment at the end of the session. We request that you provide a card on file that will bill. We don't have access to the card information, once you input it, it is encrypted in our electronic health system billing portal.
We will create a superbill for each session and submit them bi-weekly to your insurance company for you. Many places leave this obligation to you, but we feel it can be confusing and burdensome and are happy to submit the billing for you.
Your insurance company will submit any reimbursement directly to you.
If you want to be proactive, you can call the number on your insurance card and ask for the rate and percentage paid for outpatient counseling (sometimes called an office visit) out-of-network benefits.
We will have you complete and sign a release of information for your insurance company when you complete our admission paperwork. This is because your insurance company may request more information from us before determining if they will reimburse you. If you choose to seek reimbursement for sessions you pay for, be aware that your insurance can request all records they deem necessary. With your consent, we will provide records to your insurance company to assist in repayment to you.
Some of our clients prefer not to use insurance because they do not want insurance companies to base any future decisions on their treatment or diagnosis. We respect our clients right to privacy.