Superbills
If you are a client planning to use OON (Out of Network) insurance you will need to ask me for a monthly "superbill".
A superbill is like a receipt, containing the needed information for your insurance company to reimburse you after you've already made a full payment to your therapist. Insurance companies vary greatly on what type of coverage they offer for both individuals and couples, so it will be in your best interest to call them and ask some clarifying questions.
But first...
**I, Jeremy Moot under Doors Open Therapy PLLC cannot guarantee that the insurance plan you have will cover the provided therapeutic services through Superbill reimbursement. Therefore there is no monetary or biased association with any of these providers listed below. This list is purely a resource.**
Click for a list of providers that historically work well with out-of-network, associate-level clinicians:
Aetna
First Choice (some plans)
Cigna
HMA/RGA
Premara (Payment goes to patient, if not contracted w/ group)
BCBS (Payment goes to patient, if not contracted w/ group)
Lifewise (Payment goes to patient, if not contracted w/ group)
Other companies may also work well with Associate level clinicians, so please make sure to check in with your provider for confirmation.
Questions for you to consider first:
1. Are you okay with a diagnosis attached to your record?
In order to receive reimbursement from an insurer you will need a qualified diagnosis provided by me. If I do not feel there is a diagnosis that fits your insurers expectations this may mean OON coverage will not work.
2. Can you cover the full payment on your own without insurance reimbursement?
It's important to note that even if you follow all the steps necessary and get verbal agreement from your insurer, the expected reimbursement may not be provided. Make sure you have the funds to cover your therapy appointments as I cannot take any responsibility for your insurer's final choice.
Questions to ask your insurer:
**Remember to preface that these questions below are for receiving Out-of-Network coverage**
1. What are my mental health benefits?
This is just a great question to ask in general. Many are surprised to discover the various types of coverage they are allotted. For example, some don't realize that their insurance can cover for them individually AND for "family therapy"(full family or couples counseling) as well.
2. Do I have any type of deductible to fulfill first?
This is important to think about because covering that deductible might cost more than you're actually saving in a full coverage calendar.
3. Does my current plan cover working with a Licensed Mental Health Counselor Associate (LMHCA) counselor?
The word "Associate" is the important thing to stress to them. There are some insurance providers that will only reimburse for LMHC counselors.
4. Does my plan only cover a certain number of sessions?
Some insurance companies will only cover a total of 10, 20, etc sessions for a designated coverage duration.
5. How much of a reimbursement will you provide?
This is important math for you to consider in light of the deductible question above.