How to Submit Session for Reimbursement
I understand that finances are an important piece for many when choosing the right counselor. Luckily there is a potential solution! Here are the general information and steps you can take to submit sessions to your insurance for reimbursement:
Contact your Insurance Provider: You should first contact your insurance provider to verify your coverage for mental health services. You can call the number on the back of your health insurance card listed under Member Services.
You should ask about the specific requirements and documentation needed for reimbursement for an out -of-network provider. If you have out-of-network benefits, they typically will reimburse you for 60-80% of the cost of each session. Below are some questions you can ask your insurance company.
Do I have out-of-network outpatient mental health coverage? Am I able to use these benefits for telehealth?
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?
What percentage of outpatient psychotherapy sessions are covered per session?
How much will I be reimbursed for a 45 minute psychotherapy session (CPT code: 90834)?
How do I submit claim forms for reimbursement?
How long does it take for me to receive reimbursement?
Obtain a Superbill or Invoice: You can obtain a detailed invoice or “superbill” for each counseling session. These will be sent out the 1st of each month. This document should include the following information:
My name and contact information
My clinicians credentials and license information
Dates of the session
CPT (Current Procedural Terminology) or procedure code for the counseling service provided
A description of the service or treatment provided
The session fee, including any payments made by the client
Submit the Superbill to Insurance: You will need to submit the superbill or invoice to your insurance company. This is typically done by mailing the document to the insurance claims department or by submitting it through an online portal, if available.
Include Other Required Documentation: Some insurance companies may require additional documentation, such as a diagnosis from a licensed mental health professional, treatment plan, or referral from a physician. Any of these additional documents will be sent with the superbill on the 1st of the month.
Keep Records: It's important for you to maintain copies of all submitted documents, including the superbill, correspondence with the insurance company, and records of payment. These records can be important for tracking the progress of your claim and for resolving any issues that may arise. I am always happy to resend documents should you need them and answer any questions along the way!
Follow Up: After submitting the claim, you should follow up with your insurance company to check on the status of your reimbursement. This may involve contacting the insurance company's customer service or claims department.
Be Prepared for Reimbursement: If the claim is approved, the insurance company will reimburse you according to their policy and the terms of your plan. Typically they mail you a check. You should be prepared for any potential copayments, deductibles, or coinsurance that you may still be responsible for.
While this process may be new and seem overwhelming, I am happy to help you navigate it. Once you do it a few times, it will become second nature. It is important to note that not all insurance plans cover counseling services, and the coverage can vary from plan to plan. Feel free to bring any concerns or questions and ask about sliding scale, if finances are the barrier to you being connected to quality care.
