Out of Network Benefits

1.  Check your out-of-network benefits:

Typically, the Summary of Benefits is included in your member information packet or on your insurance company's website.

2.  Call your insurance company to verify, asking:

✦ What is my out-of-network deductible for outpatient mental health?
✦ What is my out-of-network coinsurance for outpatient mental health?
✦ Do I need a referral to see someone out of network?
✦ How do I submit claims for reimbursement?
✦ How much would I be reimbursed for the following CPT codes?
→  90792 for the initial evaluation, and both 99214 & 90833 for follow-up appointments.

3.  Ask the Provider for a superbill:

Ask them for a superbill and submit it to your insurance company monthly.

4.  Receive reimbursement:

You'll need to pay your Provider their entire fee at the time of service, but with out-of-network benefits, your insurance company will mail you a check to reimburse a portion of the cost.