Out-Of-Network Benefits: Don’t Leave Money on the Table!
I have been working in the mental health field for quite a while. And sometimes it is easy for me to forget that clients are not privy to all the knowledge and resources that I have acquired over the years, particularly regarding insurance benefits. Most therapists refrain from joining insurance panels in order to protect their clients’ autonomy and confidentiality. Although insurance companies lower the premium costs clients pay for their sessions, that compensation comes with the price of insurance companies acquiring access to the counselors’ notes and treatment plan as well as dictating the number of counseling sessions clients may attend. Therefore, in order to protect the confidentiality of clients’ records while also wanting to lessen treatment costs, counselors and insurance providers have agreed to a compromise known as out-of-network benefits.
So, what are out-of-network benefits? Simply put, out-of-network benefits partially reimburse clients for their therapy session fees (typically between 50% - 80%) while also ensuring the privacy of clients’ mental health records. I encourage for every individual to ask their insurance provider about the reimbursement rates for their out-of-network benefits before beginning professional mental health treatment.
Here are the steps to file an out-of-network claim.
Steps for Filing Out-Of-Network Benefits
1. Attend Your Weekly or Bi-Weekly Counseling Session
The first step is to attend your regularly scheduled counseling session with your therapist. Clients must attend their sessions in order to receive compensation from their insurance providers. Unfortunately, insurance companies do not reimburse clients who are billed for late cancellation fees. Thankfully, most counselors (including myself) do not charge clients cancellation fees if they provide their counselors with at least a 24-hour advanced notice.
2. Check Your Email for the Simple Practice Superbill
At the start of every month, the counselors’ management software, Simple Practice, emails clients their session bill receipt from the prior month. This superbill lists the client’s diagnosis, the session fees, and the client’s attendance record.
3. Submit the Superbill and Out-Of-Network Claim Form to Your Insurance Provider
Finally, email the superbill and the out-of-network claim form to your insurance provider. Below are the links to the out-of-network claim forms for each of the major insurance companies.
Aetna
Anthem (Blue Cross Blue Shield Association)
Cigna
https://www.cigna.com/static/www-cigna-com/docs/form-medical-claim.pdf
UnitedHealth Group
https://www.uhc.com/member-resources/how-to-submit-a-claim
Don’t Leave Money on the Table!
There is absolutely no reason to leave this free money on the table. You deserve to work with an experienced therapist who will support, encourage, and help you during this incredibly difficult time in your life without having to worry about financial limitations.
Now is the time to start taking care of you. You have all these tools and resources to succeed in your endeavors. And I want to provide you with the quality mental health treatment that you deserve.
It is up to you to take the next step.
Click on the link below to schedule a free 15-minute consultation with me and see if I am the right therapist for you.
References
Jones, L. (n.d.). Pros and cons of using insurance for therapy. Clarity Therapy NYC. Retrieved December 23, 2022, from https://www.claritytherapynyc.com/pros-and-cons-of-using-insurance-for-therapy/
Levy, R. (2020, June 28). 4 key reasons using insurance for therapy is a bad idea. Bucks County Anxiety Center. Retrieved December 23, 2022, from https://www.buckscountyanxietycenter.com/why-using-insurance-for-therapy-is-a-bad-idea
Schewitz, S. (2022, June 27). The real reasons (that nobody tells you) about why therapists don't accept insurance. Couples Learn. Retrieved December 23, 2022, from https://coupleslearn.com/why-therapists-dont-accept-insurance/
Why we no longer accept insurance. (n.d.). Envision Wellness. Retrieved December 23, 2022, from https://www.envisionwellness.co/why-i-no-longer-accept-insurance/