I use Thrizer, a payment platform designed to make out-of-network (OON) therapy more accessible and affordable. It allows clients to pay only their copay upfront rather than paying full session costs at the time of service.

Thrizer helps you successfully navigate your out-of-network benefits, saving you thousands on therapy and all the insurance headache.

A superbill is essentially an itemized receipt for services you have already paid for. It includes information your insurance company may need if you choose to request out-of-network reimbursement.

Please be aware that:

• Insurance companies do not always reimburse for services provided by an associate-level clinician, even with a superbill. It is important to ask this question when verifying your out-of-pocket mental health benefits.

• Reimbursement amounts can vary widely.

• Your therapist cannot communicate with insurance on your behalf.

Step 1: You can request superbills to be sent out after each appointment or monthly.

Your superbill will include:

• Date(s) of service

• Type of therapy provided

• Diagnosis code (required by insurance)

• Fees paid

• Provider information and possibly supervisor information

Step 2:‍ ‍If your insurance company requires a specific claim form, you will need to have that along with the superbill when submitting. Some insurances claim forms can be found on your insurance portal or you can request it by phone. Then you will submit the superbill to your insurance. Every insurance is different but can be offered by online portal, mail, or fax.

It is highly recommended to keep everything for your records.

Step 3: Processing times for insurance reimbursement can vary. It may take several weeks for insurance to respond to your claim.

After reviewing the claim your insurance company may:

• Send reimbursement directly to you or

• Send an Explanation of Benefits (EOB) or

• Request additional information.

If your claim is denied you can:

• Contact your insurance company for clarification

• Ask if the claim can be appealed

Before submitting a superbill, contact your insurance company. You can usually find the customer service number on the back of your insurance card.

Some important questions to ask are:

• Do I have out-of-network mental health benefits?

• Are services provided by an associate-level clinician eligible for reimbursement?

• What percentage or amount is reimbursed?

• Is there a deductive I must meet first?

• Is there a deadline for submitting claims?

• Do I need a specific claim form?

You can also check your estimated out-of-network benefits with Thrizer here.

Please note that reimbursement amounts are ultimately determined by your insurance company, and benefit estimates are not a guarantee of payment.