FAQs                                      

A superbill is a detailed invoice provided by healthcare providers that outlines the services rendered during a therapy session or medical appointment. It includes key information needed for insurance reimbursement and tax purposes. Here’s what a typical superbill includes:

1. Provider Information:

• Name, address, and contact details of the provider or practice.

• National Provider Identifier (NPI) number, if applicable.

2. Patient Information:

•    Name and date of birth of the patient.

3. Service Details:

• Date of service.

• Descriptions of the services provided or procedures performed, often including relevant codes (such as CPT codes for procedures and ICD codes for diagnoses).

4. Charges:

• Itemized list of charges for each service or procedure.

5. Payment Information:

• Amount paid by the patient (if applicable) and the balance due.

We can provide monthly superbills that you can submit to your insurance company for potential partial reimbursement, depending on your plan and deductible.

If you’d like to use out-of-network (OON) benefits, please reach out to your insurance provider to understand your coverage and the reimbursement process. It’s important to be aware of your insurance plan details.

Choosing private pay therapy has several benefits:

1. Freedom of Choice: You can select a therapist who best fits your needs without restrictions.

2. Customized Treatment: You and your therapist have the flexibility to determine the course and duration of your treatment.

3. Enhanced Privacy: Your treatment details remain confidential and are not shared with insurance companies.

4. Consistency in Care: You can continue with the same therapist, even if there are changes to your insurance.

Contact your insurance company using the phone number on the back of your insurance card.

When inquiring about out-of-network (OON) benefits with your insurance provider, consider asking the following questions:

1. Coverage Details:

• What percentage of out-of-network therapy services does my plan cover?

• Is there a maximum amount or cap on the reimbursement for OON services?

2. Deductibles and Out-of-Pocket Costs:

• Is there a separate deductible for out-of-network providers? If so, how much is it?

• Are there any additional out-of-pocket costs or co-pays associated with using out-of-network benefits?

3. Reimbursement Process:

• What is the process for submitting a claim for out-of-network services?

• Are there specific forms or documentation required for reimbursement (e.g., superbills, receipts)?

4. Claim Submission:

• How do I submit my claim? Can it be done online, by mail, or through a specific app?

• What is the typical turnaround time for processing out-of-network claims?

5. Pre-Authorization and Referrals:

• Do I need pre-authorization or a referral to receive out-of-network benefits?

• If so, how do I obtain and submit these documents?

6. Treatment Limits:

• Are there any limits on the number of out-of-network therapy sessions covered?

• Are there specific types of therapy or services that are not covered?

7. Appeals Process:

• What should I do if my claim is denied or if I disagree with the reimbursement amount?

• How do I file an appeal, and what is the process?

8. Provider Information:

• Do you need any additional information about the provider or the services rendered?

• Is there a preferred format or specific details needed for the superbill?

9. Coordination of Benefits:

• If I have secondary insurance, how does that coordinate with my primary insurance for OON benefits?