OON Coverage Instructions

How do I find out if I have out-of-network benefits?

For the most accurate answers, we recommend calling your insurance company to see if you have out-of-network benefits. If you do, they typically will reimburse you for 60-80% of the cost of each session.

The best way to get in contact with someone from your insurance company is to call the number on the back of your health insurance card listed under Member Services.

You should ask the representative the following questions:

  • Do I have out-of-network outpatient mental health coverage? 

  • Am I able to use these benefits for telehealth and in-person appointments?

  • 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?

  • How much will I be reimbursed for a 50 minute psychotherapy session (CPT code: 90834)?

  • How do I submit claim forms for reimbursement?  

  • How long does it take for me to receive reimbursement?

  • If you are seeing Elizabeth Tullis,  ask if they cover reimbursement for pre-licensed clinicians.

 

If appropriate, we will provide you with monthly invoices called a “super bill” that will include all of the necessary information for your claims to be processed. This will be automated on the last day of each month and sent through the Simple Practice Client Portal.