Out-Of-Network Benefits, Explained:

I provide therapy using out-of-network benefits, meaning that I am able to bill client’s insurance who have an insurance policy that participates in utilization of out-of-network benefits.

As a mental health provider, utilizing out-of-network benefits allows my clients the freedom of choice in their provider. I provide speciality mental health care treating Perinatal Mental Health, Trauma Disorders and Substance Use Disorders. When you utilize out-of-network benefits, you are not limited to only mental health providers who are in-network with your insurance. This allows a greater selection, more specialized treatment, and likely, the opportunity to have a better “match” with your therapist.

So, how do out-of-network benefits work?

To put it simply, you will pay for your therapy session out of pocket, then your therapist will provide you with a superbill or send a superbill to your insurance on your behalf detailing what you paid for your session, and, as long as your out-of-network benefits cover outpatient mental health therapy sessions, they will typically reimburse you directly for a portion if not most of the cost that you paid for your session.

It is IMPORTANT for you to contact your insurance provider and verify the following:

• That you have out-of-network benefits that you can use toward mental health counseling sessions

• If you have a deductible that needs to be met prior to being reimbursed for sessions (and what the deductible is currently at)

• That you will be reimbursed a percentage of your paid session fee (make sure to ask what the reimbursement percentage is)

• Whether or not you need to submit your superbill or if your therapist can send it in on your behalf

  Once you have verified this information, you should be ready to make a decision about utilizing out-of-network benefits for your therapy session!

  If you are a prospective client and need more guidance around utilization of out-of-network benefits, please don’t hesitate to reach out to me at meghan@reflecttoconnectmhc@gmail.com.