How to Submit a Superbill
Understanding your out of network benefits
Would you be surprised if I told you that even if your therapist doesn’t accept your insurance, that your insurance company may cover all, or a portion of your therapy services? It’s true! Whether or not your insurance will reimburse you for therapy is unique to your specific policy within your insurance company and their requirements for mental health coverage.
To find out how to get reimbursed for therapy, call the phone number on the back of your insurance card and ask these questions.
How do out of network benefits work?
Simply put, out of network benefits pay the client back for services, instead of paying the provider. Clients submit a “superbill” to the insurance company, and the insurance company pays the client back.
When a provider is out of network, the client pays the provider directly for services. Clients can request a superbill from their provider and use that information to seek full or partial reimbursement from their insurance company by submitting an out of network claim. Your insurance company will process the claim, determine how much you can get reimbursed, and will usually mail you a check.
If you have a deductible to meet, submitting superbills from your out of network providers may count towards your overall deductible or out of pocket maximum.
What’s the difference between “private pay” and “out of network”?
Typically, providers who are “private pay” do not offer superbills and clients are unable to seek potential reimbursement from your insurance company.
Providers who are “out of network” often are willing to provide superbills, which may allow you to use your out of network insurance benefits to get potential reimbursement for the costs of therapy.
Is Sea Glass out of network or private pay?
Currently, Sea Glass is considered an “out of network” for all insurance companies and we are happy to provide a superbill if you wish.
What is a superbill?
First, what even is a superbill? Simply put, a “superbill” is an itemized medical receipt. It has all of the information you need from your therapist in order to submit a claim to your insurance company for potential reimbursement.
A superbill should contain several pieces of information: the name, tax ID, and contact information for the business; the name and National Provider Identifier (NPI) number of your therapist; your name, birthdate, and contact information; your mental health diagnosis; dates of service; procedure codes (CPT codes) for services provided; place of service codes; and cost paid for services. It sounds like a lot, but it’s all easily laid out so it’s easy to find what you need.
How do I submit a superbill?
The easiest way I’ve found is to log into your insurance company’s member website, navigate to “Claims” and you should have some option to “submit a claim.” You may be prompted to enter the information found on your superbill and/or upload the document. Contact your insurance company directly for assistance.
Other companies like Reimbursify and Thrizer can help clients submit superbills. The downside of using a service like this is that they usually take a small percentage of your reimbursement as payment for their services.
Sea Glass Counseling and Consultation is an EMDR therapy practice in Dublin, Ohio. Our compassionate, skilled therapists use evidence-based techniques grounded in the neurobiology of stress, trauma, and relationships to make sure your treatment is personalized and effective. Sea Glass therapists provide telehealth counseling in Ohio for individuals and couples. We’re best known for providing Intensive EMDR therapy, anxiety treatment, and sex therapy for Christians. Interested in working together? Contact us today to get started with an EMDR or couples therapist in Ohio.