Want to use Out-of-Network benefits? Here’s how:

—Have your insurance card at the ready.

—Have pen/pencil and paper handy. Or whatever device(s) that work well for you to make notes.

—Call the designated phone number on your insurance card.

—Speak with a staff member who can tell you about your Out-of-Network outpatient mental healthcare benefits.

—Write down the date of your call along with the name of the staff person(s) you spoke with. Ask for and write down the call confirmation number, too.

BASIC QUESTIONS

—Ask: Do I Have Out-of-Network benefits for outpatient mental health care?

—If yes, then ask: What is my annual out-of-network deductible? Ask them if you have already met the OON deductible this year, and if not, how much remains before the insurance company begins reimbursing you for your OON costs.

—Ask: What amounts do my OON benefits pay for these codes?: 90791, 90837, 90847, 90846.

—Ask: Is there an OON out-of-pocket maximum? If so, how much is it, and how much does insurance pay if you meet that maximum. You could also ask how much you’ve paid toward your OON out-of-pocket maximum.

—Ask: How do I file OON claims? What do they require in order for you to access your OON benefits (I.e., Super Bill, claim form, etc.). Find out where and how to send the request for reimbursement (e.g., physical address, email address, fax number). I also would ask which method they prefer, and I would ask when you should expect to receive payment following each claim you file.

—Ask them if there is anything else that would be helpful for you to know regarding filing for OON benefits.

That should get you solid, useful info from your insurance company! If not, let me know.

Then let me know the frequency you would prefer for the Super Bills (e.g., monthly, bi-monthly, etc.) and we will make it happen.

Out of Network (OON) Recap:

  • Pay me in full each appointment day

  • Get a Super Bill from me at the frequency you prefer (e.g., Bi-weekly, Monthly, Every two months, etc.)

  • You file OON claims with your insurance company

  • You receive money back from your insurance company that is yours to use as you wish. Bravo! 

Ready to get Started? Questions?