Here are two great ways to learn more about your Out of Network coverage!
1) Check out this 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 under Member Services to see if you have out-of-network benefits. If you have OON coverage, they typically will reimburse you for 60-80% of the cost of each session.
Below are questions you can ask your insurance representative if you decide to call:
- 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?
Upon request, I will provide you with monthly invoices called a “superbill” 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.
