Here are two great ways to learn more about your Out of Network coverage!
1) Using this link, you can use this awesome OON benefits calculator from Mentaya.
2) If you prefer to contact your insurance company directly, you can call the number on the back of your insurance card to see if you have out-of-network benefits. If you do, they typically will reimburse you for 60-80% of the cost of each session. The best way to get in contact with someone from your insurance company is to call the number on the back of your health insurance card listed under Member Services.
If you call your insurance company, you should ask the representative the following questions:
- Do I have out-of-network outpatient mental health coverage?
- Am I able to use these benefits for telehealth and in-person appointments?
- What is my out-of-network deductible?
- How much of my deductible has been met this year?
- Do I need a referral from an in-network provider to see someone out-of-network?
- How much will I be reimbursed for a 50 minute psychotherapy session (CPT/Service code: 90834)?
- How do I submit claim forms for reimbursement?
- How long does it take for me to receive reimbursement?
If appropriate, we will provide you with monthly invoices called a “super bill” that will include all of the necessary information for your claims to be processed. This will be automated on the last day of each month and sent through the Simple Practice Client Portal.
