Using Your Out-of-Network Benefits for Mental Health Counseling

Finding out that your therapist is transitioning from an in-network provider to an out-of-network provider can be stressful. However, you may still be able to use your insurance benefits—if your plan includes out-of-network coverage.  

Here are a few tips to help you navigate this process:

1. Call Your Insurance Provider 

Ask the following questions: 

- Do I have out-of-network benefits for mental health services? 

- What is my deductible, and has any of it been met? 

- What percentage of each session will be reimbursed after the deductible is met? 

- Is there a limit to how many sessions are covered per year? 

- Do I need a referral or prior authorization? 

2. Get a Superbill from Your Therapist 

A superbill is a detailed receipt that includes all the information your insurance company needs to process a claim, including: 

- Your therapist's name, license, and NPI number 

- Diagnosis and service codes 

- Dates and fees of each session 

3. Submit the Superbill to Your Insurance 

You can usually upload the superbill through your insurance provider's member portal or send it in by mail. Check with them for the exact process. 

4. Track Your Claims 

Follow up to make sure the claim was received and processed. Reimbursement typically takes a few weeks. Keep copies of everything for your records. 

5. Use Apps That Help 

Consider apps like Reimbursify, Thrizer, or Mentaya to streamline the process of submitting claims and getting reimbursed. 

*** While out-of-network reimbursement can take a little extra effort, it's often worth it to work with a therapist who's the right fit for you.