Before starting therapy, it’s important to check with your insurance company to understand how your out-of-network benefits work. Here are some key questions to ask:

1. What is my out-of-network coverage for outpatient mental health visits?
– Ask about how much your plan will reimburse for therapy sessions with an out-of-network provider.

2. Is there a deductible that needs to be met prior to services? How much of my deductible has been met this year?
– Find out if you have a deductible, and if so, how much you need to pay before your insurance begins to cover services.

3. Is there a limit on the number of sessions my plan will cover per year? If Yes, how many?
– Some plans limit the number of sessions they will cover, so it’s important to know if there is a cap.

4. Is there an “allowed” amount that will be reimbursed?
– Ask about the maximum amount your insurance will pay for each therapy session.

5. Do I need pre-authorization to start therapy?
– Some plans may require a referral from a primary care physician or an in-network provider before seeing an out-of-network therapist.

6. How do I submit claims for out-of-network reimbursement?
– Find out the process for submitting your superbill to your insurance company for reimbursement.

7. Is there anything else I need to know about using my out-of-network benefits?
– Be sure to ask about any other rules, limitations, or details that may affect your coverage.

Once you have this information, I will provide you with a superbill that includes the necessary codes (CPT code for the service and a diagnosis code) so you can submit it to your insurance for potential reimbursement.