Insurance - "out-of-network"
I am an eligible "out-of-network" provider in North Carolina. If you wish to claim insurance reimbursement for counseling services, call your plan and ask the following questions about "out-of-network outpatient mental health benefits":
It is important that you contact your insurance provider to learn the details of your particular plan.
- Do you reimburse for psychotherapy with out-of-network licensed mental health counselors?
- What is my (or my family's) annual deductible?
- Is there a maximum number of sessions allowable per year, and if so how many?
- What percentage of the provider's fee is reimbursed?
It is important that you contact your insurance provider to learn the details of your particular plan.
As an out-of-network provider, my procedure is as follows:
This arrangement is called "third-party reimbursement."
The insurance company may contact you requesting additional information. Sometimes they have trouble processing superbills. The insurance company may also contact me to verify that you are in treatment or for additional provider information.
- You pay me directly and in full.
- I provide you with a quarterly superbill.**
- You send your insurance company a copy of the superbill.
- They reimburse your claim, per their policies.
**Most insurance companies require a diagnosis of a mental-health condition. This diagnosis is included on the superbill and goes on your record with the insurance company.
This arrangement is called "third-party reimbursement."
The insurance company may contact you requesting additional information. Sometimes they have trouble processing superbills. The insurance company may also contact me to verify that you are in treatment or for additional provider information.