Accessing Out of Network Health Insurance Benefits : Reimbursement Options

Aug 23

When utilizing Out of Network benefits you’ll likely need to pay your therapist the entire session fee at the time of service, and depending on your specific plan, your insurance company will mail you a check to reimburse a portion of that cost.

For information about how to Learn about your Out of Network Benefits, check out my blog post on this.

Some therapists have options to submit Out of Network Claims on your behalf and may establish their own policies and practices such as “Balance Billing” where the therapist will submit an out of network claim on the client’s behalf and the client will be responsible for a portion of the billed amount - depending upon the Insurance Company’s practices and policies. Other therapists may offer options to submit SuperBills on behalf of clients and have reimbursement sent directly to the client through various apps or billing services.

Ask your Therapist for a SuperBill

Some therapists have the option to give you something called a Superbill. This is essentially a fancy receipt with all the information your insurance company will need to file a claim. Once you get your Superbill from your therapist you can then use it to submit a claim for reimbursement following the processes outlined in the information you learned when you contacted your insurance company.

Submit the SuperBill to your Insurance Company Directly or Via an App

There are several ways to file a claim for reimbursement. Some insurance companies require you to do it through their website but you may also be able to use an app. There are a few options, the most common being Reimbursify. Reimbursement apps will help you through the process of filing claims, though they may charge a small fee.

Commonly Used Apps to file Out of Network Benefit Claims

I have not utilized these apps - yet - so I am not able to comment on how they work, but want to share these as options for current and prospective clients.