As a private pay therapist, clients pay me directly for services. However, clients may receive reimbursement from their insurance company for therapy services through their out-of-network (OON) benefits.
Here’s the process:
- Your card on file will be charged the fee after our session on the date of service.
- I will provide you with a receipt known as a “superbill.” Clients receiving weekly therapy typically choose to receive a monthly superbill.
- You will upload that superbill to your insurance company’s website, often through a button inviting you to “Submit a Claim.”
- Your insurance company will reimburse you a percentage of what you paid, in accordance with your specific plan. This is usually mailed to clients as a paper check.
If the executive functioning of this process feels daunting, there are services like Reimbursify that can handle the process for you for a small fee.
Questions for your insurance company:
If you want to know more about your policy’s specific procedures and benefits, I recommend calling your insurance company and asking any questions you may have.
- Does my plan cover outpatient individual therapy with a Licensed Marriage and Family Therapist (LMFT)?
- What are my out-of-network benefits for those services?
- Do I have a deductible or co-pay? How much?
- What is the process for submitting a claim? Where do I upload superbills?
- How much will I be reimbursed for each session?
- What is the timeline for receiving reimbursement?
Information you may need:
At any point along the process, your insurance company may ask you for any of the following information (all of which is also included in your superbill).
- CPT code for first session: 90791
- CPT code for psychotherapy: 90837
- NPI: 1245098904
- EIN: 86-1242246
- Therapist name: Rachel Rainbolt
- License number: MFT.LF.70057868
- Therapy location: Telehealth
*Note: Clients are responsible for any and all communication with their insurance company.
While I continue to advocate for a community care model of social governance in which health care is easily accessible, services are client-centered, and therapists are compensated with a living wage, this private pay model with superbills for out-of-network insurance reimbursement is the most values aligned way of honoring needs in the therapeutic space that I can offer.
