Out of Network FAQ
Are you thinking...The therapist I want to see doesn't take insurance, now what?
Many insurance companies offer an “out-of-network” benefit which allows you to see any therapist, pay the therapist directly, and then be partially reimbursed by your insurance provider. I accept most HSA/FSA cards, in addition to all major credit cards. and can provide you with receipt, often called a superbill, to submit to your insurance company for reimbursement. Many insurance companies will cover 50-100% of my fee as an “out-of-network” provider.
How do I determine if I have out-of-network benefits?
Contact your insurance company directly by calling the customer service phone number on the back of your insurance card (there is often a separate phone number for mental health or “behavioral health” services information). When speaking with your insurance company, asking them the following questions can be helpful in getting all the information you need:
What are my out-of-network outpatient mental health benefits? How much of each therapy session will you reimburse (this is typically a percentage)?
Do they reimburse the same for TELEHEALTH, VIDEO, PHONE, TELEMENTAL HEALTH sessions with out of network providers? If yes, do they anticipate and end-date for this?
Do I need to meet an out-of-network deductible (the amount of money you have to pay before your insurance company will start to reimburse you) before my benefits will begin reimbursement for out-of-network providers? How much of this deductible have I already paid?
Are there any limitations to services (e.g., only a certain amount of money allowed for mental health reimbursements, a limited number of sessions, reimbursement only for certain types of diagnoses, etc.)?
Do I need any kind of special referral (i.e., from a primary care doctor) before I can be reimbursed?
How do I submit my out-of-network claim? How long will it take to get reimbursed after I submit my receipt?
Do my benefits cover online counseling?
Where can I get help with my insurance benefits?