Understanding Your Out-of-Network Benefits:

Utilizing your out-of-network benefits can be a powerful way to prioritize your well-being by choosing the best possible care that aligns with your specific needs. It is a valuable tool within your insurance plan designed to give you greater flexibility and choice in your mental health journey. We are here to support you in navigating this process. Please review the following information regarding what to expect when using your out-of-network insurance benefits.

Know Your Benefits:

Log into your insurance company's website or call member services (or the mental health services number) to find your plan documents and mental health coverage details.

  • Ask about:

    • Out-of-network outpatient professional mental health benefits.

    • Out-of-network deductible amount and how much has been met.

    • Out-of-pocket maximum amount and how much has been met.

    • When your deductible and out-of-pocket maximum renew (usually January 1).

    • Your cost-share (copay or coinsurance) for out-of-network outpatient professional mental health services after your deductible is met.

    • Whether a referral, prescription, or preauthorization from your primary care physician is needed.

    • Any limits on the number of sessions covered per week or year.

    • Whether your plan covers telehealth (online therapy) services.

  • Understand how to submit claims.

Payment Process:

  • For our mutual convenience, we require a credit card on file so that payments can be processed automatically (see our Payment Policies page for more information).

  • Your card on file will be charged our full fee at the time of service. We do not offer fee discounts or sliding scale options when you utilize your out-of-network insurance benefit. The discount offered by your insurance provider is almost always higher than the discount we are able to provide with a sliding scale. 

  • We will send you a monthly superbill (detailed receipt) with all information required by your insurance company for reimbursement.

  • You will submit the superbill to your insurer (often through their patient portal).

  • Your insurance company will send you a check for their portion of the cost-share.